Provider Demographics
NPI:1033116033
Name:KNOTT, KRISTINE RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:RENEE
Last Name:KNOTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2082 SWAN POND RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-0233
Mailing Address - Country:US
Mailing Address - Phone:304-263-0099
Mailing Address - Fax:304-754-3400
Practice Address - Street 1:436 FEATHERBED RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-0375
Practice Address - Country:US
Practice Address - Phone:304-676-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist