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General NPI Number Information
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NPI Number | 1215317797
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Entity Type | Individual
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Provider Name | JEFF KNOLL
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Gender | Male
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 4101 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1326
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Country | US
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Telephone | 412-864-9314
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WEAVER DR
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City | GLENSHAW
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State | PA
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Zip | 15116-1423
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Country | US
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Telephone | 412-352-6943
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP008217
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License Number State | PA
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