Healthcare Provider Details

I. General information

NPI: 1245059591
Provider Name (Legal Business Name): AMBER KNOX RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E GREEN DR
HIGH POINT NC
27260-6707
US

IV. Provider business mailing address

4356 MORNING RIDGE LN
WINSTON SALEM NC
27101-2275
US

V. Phone/Fax

Practice location:
  • Phone: 336-641-7802
  • Fax:
Mailing address:
  • Phone: 336-582-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number283444
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: