Provider Demographics
NPI:1114166923
Name:KNOX, BERNICE
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:
Last Name:KNOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HYETTS CORNER RD
Mailing Address - Street 2:NCCVT SCHOOL DISTRICT
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8907
Mailing Address - Country:US
Mailing Address - Phone:302-449-3603
Mailing Address - Fax:449-376-6796
Practice Address - Street 1:555 HYETTS CORNER RD
Practice Address - Street 2:NCCVT SCHOOL DISTRICT
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8907
Practice Address - Country:US
Practice Address - Phone:302-449-3603
Practice Address - Fax:449-376-6796
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL20005608164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse