Healthcare Provider Details

I. General information

NPI: 1578483897
Provider Name (Legal Business Name): JOSIAH KNISLEY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6949 GOOD SAMARITAN DR
CINCINNATI OH
45247-5204
US

IV. Provider business mailing address

6949 GOOD SAMARITAN DR
CINCINNATI OH
45247-5204
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-9907
  • Fax: 513-246-9967
Mailing address:
  • Phone: 513-246-9907
  • Fax: 513-246-9967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number419469
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: