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General NPI Number Information
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NPI Number | 1346282902
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Entity Type | Organization
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Legal Business Name | KNOX FAMILY WELLNESS CLINIC, P.A.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 609 S AVENUE F
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City | KNOX CITY
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State | TX
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Zip | 79529-2103
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Country | US
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Telephone | 940-657-4457
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Fax | 940-657-4456
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Provider Business Mailing Address
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Address Line | 609 S AVENUE F
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City | KNOX CITY
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State | TX
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Zip | 79529-2103
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Country | US
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Telephone | 940-657-4457
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Fax | 940-657-4456
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KAREN EVON STIEWERT
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Credential | FNP-C
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Telephone | 940-657-4457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F1105025
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License Number State | TX
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