Healthcare Provider Details

I. General information

NPI: 1629073937
Provider Name (Legal Business Name): KRISTIE HAWK KNIGHT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 2ND ST
NEWPORT TN
37821-3703
US

IV. Provider business mailing address

154 OLD COSBY RD
NEWPORT TN
37821-2998
US

V. Phone/Fax

Practice location:
  • Phone: 423-625-2216
  • Fax:
Mailing address:
  • Phone: 423-625-2216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberC008238
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: