Provider Demographics
NPI:1366867350
Name:KNOTT, JILL CAROL (RN)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:CAROL
Last Name:KNOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 272ND ST NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-9530
Mailing Address - Country:US
Mailing Address - Phone:360-403-3623
Mailing Address - Fax:360-629-1341
Practice Address - Street 1:26920 PIONEER HWY
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-9548
Practice Address - Country:US
Practice Address - Phone:360-403-3623
Practice Address - Fax:360-629-1341
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00092418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse