Provider Demographics
NPI:1710247499
Name:KNOX, SHANNON (AUD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:KNOX
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7675 WOLF RIVER CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1750
Mailing Address - Country:US
Mailing Address - Phone:901-682-1529
Mailing Address - Fax:
Practice Address - Street 1:6616 KIRBY CENTER CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4313
Practice Address - Country:US
Practice Address - Phone:901-363-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA00000001626231H00000X
ARA#356231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist