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General NPI Number Information
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NPI Number | 1679943690
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Entity Type | Individual
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Provider Name | RACHEL MCKNIGHT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 14 KIMBERLY DR
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City | VILONIA
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State | AR
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Zip | 72173-9018
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Country | US
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Telephone | 501-733-9302
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Fax |
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Provider Business Mailing Address
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Address Line | 14 KIMBERLY DR
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City | VILONIA
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State | AR
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Zip | 72173-9018
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Country | US
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Telephone | 501-733-9302
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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 | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | A004513
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License Number State | AR
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