Provider Demographics
NPI:1114267739
Name:DAVID KNIOLA CRNP LLC
Entity Type:Organization
Organization Name:DAVID KNIOLA CRNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:256-375-9127
Mailing Address - Street 1:825 WOODS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:AL
Mailing Address - Zip Code:35096-5874
Mailing Address - Country:US
Mailing Address - Phone:256-375-9127
Mailing Address - Fax:615-348-0109
Practice Address - Street 1:825 WOODS FERRY RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AL
Practice Address - Zip Code:35096-5874
Practice Address - Country:US
Practice Address - Phone:256-375-9127
Practice Address - Fax:615-348-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-068065310400000X, 313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility