Healthcare Provider Details

I. General information

NPI: 1386423580
Provider Name (Legal Business Name): CHRISTIE ANN KNECHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTIE ANN SMITH

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35959 N 7TH AVE
DESERT HILLS AZ
85086-6306
US

IV. Provider business mailing address

35959 N 7TH AVE
DESERT HILLS AZ
85086-6306
US

V. Phone/Fax

Practice location:
  • Phone: 623-445-3510
  • Fax:
Mailing address:
  • Phone: 623-445-3510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number5572410-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: