Provider Demographics
NPI:1518951656
Name:KNOLL, KURT MICHAEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:MICHAEL
Last Name:KNOLL
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2910 S CHURCH ST STE B
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-7149
Mailing Address - Country:US
Mailing Address - Phone:615-895-3600
Mailing Address - Fax:615-895-0024
Practice Address - Street 1:2910 SOUTH CHURCH STREET, SUITE B
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-7149
Practice Address - Country:US
Practice Address - Phone:615-895-3600
Practice Address - Fax:615-895-0024
Is Sole Proprietor?:No
Enumeration Date:2005-09-05
Last Update Date:2012-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN1073363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant