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: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
990 HAMMOND DR STE 600
SANDY SPRINGS GA
30328-5510
US
IV. Provider business mailing address
3300 N TRIUMPH BLVD STE 500
LEHI UT
84043-6475
US
V. Phone/Fax
- Phone: 678-861-1832
- Fax:
- Phone: 801-821-2333
- Fax: 801-901-1194
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN304782 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | RN304782 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: