Healthcare Provider Details

I. General information

NPI: 1114295672
Provider Name (Legal Business Name): DEBORA KNOX RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E GREEN DR
HIGH POINT NC
27260-6707
US

IV. Provider business mailing address

501 E GREEN DR
HIGH POINT NC
27260-6707
US

V. Phone/Fax

Practice location:
  • Phone: 336-641-5541
  • Fax: 336-641-7987
Mailing address:
  • Phone: 336-641-5541
  • Fax: 336-641-7987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number82869
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: