Healthcare Provider Details

I. General information

NPI: 1497644306
Provider Name (Legal Business Name): ANGELA PAIGE MCKNIGHT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 N GERMANTOWN PKWY STE 112
CORDOVA TN
38016-7412
US

IV. Provider business mailing address

1374 CORDOVA CV STE 102
GERMANTOWN TN
38138-2220
US

V. Phone/Fax

Practice location:
  • Phone: 901-922-5425
  • Fax: 901-922-5433
Mailing address:
  • Phone: 901-509-2714
  • Fax: 901-509-2604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39152
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: