Provider Demographics
NPI:1467785022
Name:KNOTT, KIMBERLY M (ARNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:KNOTT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S FLOYD ST
Mailing Address - Street 2:SUITE 804
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1835
Mailing Address - Country:US
Mailing Address - Phone:502-583-0127
Mailing Address - Fax:502-583-1239
Practice Address - Street 1:601 S FLOYD ST
Practice Address - Street 2:SUITE 804
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1835
Practice Address - Country:US
Practice Address - Phone:502-583-0127
Practice Address - Fax:502-583-1239
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6108P363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal