Healthcare Provider Details

I. General information

NPI: 1811155542
Provider Name (Legal Business Name): DAPHNE HARRINGTON KNICELY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAPHNE MELVINA HARRINGTON M.D.

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PINNACLE DR STE A03
FISHERSVILLE VA
22939-2367
US

IV. Provider business mailing address

PO BOX 749112
ATLANTA GA
30374-9112
US

V. Phone/Fax

Practice location:
  • Phone: 844-472-8711
  • Fax: 844-472-8712
Mailing address:
  • Phone: 999-999-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0101251852
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: