Healthcare Provider Details

I. General information

NPI: 1477466993
Provider Name (Legal Business Name): JOELLE MCKNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 LINCOLN COURT AVE NE
BROOKHAVEN GA
30329-1822
US

IV. Provider business mailing address

927 LINCOLN COURT AVE NE
BROOKHAVEN GA
30329-1822
US

V. Phone/Fax

Practice location:
  • Phone: 678-886-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN296889
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: