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General NPI Number Information
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NPI Number | 1083203350
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Entity Type | Individual
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Provider Name | TRACEY MARQUIETA KNUTSON APRN
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 3298 SUMMIT BLVD, BLDG 22, STE A1
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City | PENSACOLA
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State | FL
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Zip | 32503
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Country | US
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Telephone | 850-712-4766
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Fax |
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Provider Business Mailing Address
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Address Line | 3298 SUMMIT BLVD, BLDG 22, STE A1
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City | PENSACOLA
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State | FL
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Zip | 32503
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Country | US
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Telephone | 850-712-4766
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11010976
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11010976
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License Number State | FL
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