Provider Demographics
NPI:1225350275
Name:KNIFLEY, SHONA DAWN (PA)
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:DAWN
Last Name:KNIFLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 DANNAHER DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4039
Mailing Address - Country:US
Mailing Address - Phone:865-524-7107
Mailing Address - Fax:865-524-3709
Practice Address - Street 1:7730 DANNAHER DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4039
Practice Address - Country:US
Practice Address - Phone:865-524-7107
Practice Address - Fax:865-524-3709
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1828363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1031975869OtherMEDICARE ID #