MEDICARE: KRISTIE HAWK KNIGHT PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	C008238	TN

General Provider Information

NPI Number	:	1629073937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIE HAWK KNIGHT PHARMD

Provider Business Mailing Address
First Line	:	154 OLD COSBY RD
Second Line	:
City	:	NEWPORT
State	:	TN
Zip	:	37821-2998
Country	:	US
Telephone Number	:	423-625-2216
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 2ND ST
Second Line	:
City	:	NEWPORT
State	:	TN
Zip	:	37821-3703
Country	:	US
Telephone Number	:	423-625-2216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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