Healthcare Provider Details

I. General information

NPI: 1700419660
Provider Name (Legal Business Name): ALISON R KNOTTS MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 HOLLY ST
ORANGEBURG SC
29115-4930
US

IV. Provider business mailing address

514 EASTWOOD CIR
ORANGEBURG SC
29118-8708
US

V. Phone/Fax

Practice location:
  • Phone: 803-531-2722
  • Fax:
Mailing address:
  • Phone: 803-614-5405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24216
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201678
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: