Healthcare Provider Details

I. General information

NPI: 1568722866
Provider Name (Legal Business Name): ANN MARIE THOMAS KNIGHT RN,BSN,MSN,MBA,NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 EXECUTIVE DR SUITE H
DANVILLE VA
24541-4155
US

IV. Provider business mailing address

125 EXECUTIVE DR SUITE H
DANVILLE VA
24541-4155
US

V. Phone/Fax

Practice location:
  • Phone: 434-791-1345
  • Fax: 434-791-2663
Mailing address:
  • Phone: 434-791-1345
  • Fax: 434-791-2663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024170050
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: