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NPI Code Detail

MEDICARE: YONAH KNUCKLES NP

MEDICARE: YONAH KNUCKLES NP
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
1363LG0600XGerontology Nurse PractitionerAP137138TX

General Provider Information

NPI Number : 1609198936
Entity Type Code : Individual
Provider Name (Legal Business Name) : YONAH KNUCKLES NP
Provider Business Mailing Address
First Line : 1212 RUTHELLA DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-3530
Country : US
Telephone Number : 817-223-5790
Fax Number :
Provider Business Practice Location Address
First Line : 6363 N STATE HIGHWAY 161 STE 100
Second Line :
City : IRVING
State : TX
Zip : 75038-2239
Country : US
Telephone Number : 469-200-3272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2010
Last Update Date : 01/03/2025

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