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General NPI Number Information
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NPI Number | 1699492637
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Entity Type | Individual
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Provider Name | CAROLYN MARIE MCKNIGHT FNP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 121 CORDOBA CENTER DR STE 400
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City | HOT SPRINGS VILLAGE
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State | AR
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Zip | 71909-4036
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Country | US
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Telephone | 501-915-0837
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Fax | 501-915-0978
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Provider Business Mailing Address
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Address Line | 1466 CONES RD
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8707
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Country | US
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Telephone |
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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 | 221894
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License Number State | AR
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