Healthcare Provider Details

I. General information

NPI: 1851038301
Provider Name (Legal Business Name): ELLEN KNOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 COMMERCIAL BLVD
CINCINNATI OH
45245-2900
US

IV. Provider business mailing address

4092 MAXWELL DR
MASON OH
45040-6500
US

V. Phone/Fax

Practice location:
  • Phone: 513-288-6590
  • Fax: 513-445-8582
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0034795
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number475825
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: