Healthcare Provider Details
I. General information
NPI: 1326104357
Provider Name (Legal Business Name): ARNITA GERTRUDE KNOTT MSN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/27/2006
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4727 SAINT ANTOINE ST SUITE 210
DETROIT MI
48201-1461
US
IV. Provider business mailing address
1904 THORNHILL PL
DETROIT MI
48207-3824
US
V. Phone/Fax
- Phone: 313-831-3066
- Fax: 313-831-8438
- Phone: 313-393-1427
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 4704108032 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 4704108032 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: