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General NPI Number Information
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NPI Number | 1821248550
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Entity Type | Individual
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Provider Name | AARON PRESTELLE MCKNIGHT APRN
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Gender | Male
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 06/01/2025
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Provider Practice Location Address
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Address Line | AUTUMN LAKE HEALTHCARE 400 BRITTANY FARMS RD
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City | NEW BRITAIN
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State | CT
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Zip | 06053
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Country | US
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Telephone | 619-905-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 MANCHESTER RD
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City | GLASTONBURY
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State | CT
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Zip | 06033-2631
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Country | US
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Telephone | 619-905-1980
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 14840
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State |
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