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General NPI Number Information
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NPI Number | 1649712423
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Entity Type | Individual
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Provider Name | PEGGY KNOX
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Gender | Female
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 726 BRANCHVIEW DR
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City | MANNING
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State | SC
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Zip | 29102-2032
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Country | US
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Telephone | 803-410-0397
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Fax |
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Provider Business Mailing Address
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Address Line | 726 BRANCHVIEW DR
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City | MANNING
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State | SC
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Zip | 29102-2032
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Country | US
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Telephone | 803-410-0397
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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