MEDICARE: THERESA H MCKNIGHT APNC RNC

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	363LF0000X	Family Nurse Practitioner	APN00178	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437147600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA H MCKNIGHT APNC RNC

Provider Business Mailing Address
First Line	:	5410 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3307
Country	:	US
Telephone Number	:	702-362-2500
Fax Number	:	702-876-6581

Provider Business Practice Location Address
First Line	:	5410 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3307
Country	:	US
Telephone Number	:	702-362-2500
Fax Number	:	702-876-6581

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	04/23/2012

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