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General NPI Number Information
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NPI Number | 1417608852
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Entity Type | Organization
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Legal Business Name | IKNOW CPR AND MORE LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 3140 CANNON DR
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City | MANSFIELD
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State | TX
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Zip | 76063-5533
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Country | US
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Telephone | 469-686-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 3140 CANNON DR
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City | MANSFIELD
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State | TX
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Zip | 76063-5533
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Country | US
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Telephone | 757-748-4643
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTAL OUTLAW
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Credential | FNP-C
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Telephone | 757-748-4643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number |
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License Number State |
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