Provider Demographics
NPI:1821290818
Name:KNOX, MARGUERITE LOVETT (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:LOVETT
Last Name:KNOX
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SWEETWATER DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061-9209
Mailing Address - Country:US
Mailing Address - Phone:803-776-7916
Mailing Address - Fax:803-647-9513
Practice Address - Street 1:1325 S CAROLINA RD STE 29
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:SC
Practice Address - Zip Code:29044-5000
Practice Address - Country:US
Practice Address - Phone:803-806-2071
Practice Address - Fax:803-806-2072
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2424363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2424OtherADVANCED PRACTICE RN
SC2424OtherPRESCRIPTIVE AUTHORITY