Healthcare Provider Details

I. General information

NPI: 1942064035
Provider Name (Legal Business Name): WILLIAM CHANDLER KNIGHT APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COLONIAL CENTER PKWY STE 350
ROSWELL GA
30076-4893
US

IV. Provider business mailing address

300 COLONIAL CENTER PKWY STE 350
ROSWELL GA
30076-4893
US

V. Phone/Fax

Practice location:
  • Phone: 678-861-1832
  • Fax: 678-585-2259
Mailing address:
  • Phone: 678-861-1832
  • Fax: 678-585-2259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN304782
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN304782
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: