MEDICARE: ELIZABETH MCKNIGHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	26243-C	AR

General Provider Information

NPI Number	:	1427643162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MCKNIGHT

Provider Business Mailing Address
First Line	:	3000 UNITED FOUNDERS BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3958
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9714 MAUMELLE BLVD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72113-6737
Country	:	US
Telephone Number	:	731-693-9909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2021
Last Update Date	:	08/30/2024

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