Healthcare Provider Details

I. General information

NPI: 1780354092
Provider Name (Legal Business Name): MELISSA ANN KNOX FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 BLUFFS AVE STE 102
ELKO NV
89801-2488
US

IV. Provider business mailing address

808 ABEYTA DR
SPRING CREEK NV
89815-5442
US

V. Phone/Fax

Practice location:
  • Phone: 775-738-1212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number826538
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: