Provider Demographics
NPI:1962837450
Name:KNOTT, MELINDA A (APRN-BC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:A
Last Name:KNOTT
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-0525
Mailing Address - Country:US
Mailing Address - Phone:731-986-2213
Mailing Address - Fax:731-986-0011
Practice Address - Street 1:193 JIM ADAMS DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4965
Practice Address - Country:US
Practice Address - Phone:731-641-6461
Practice Address - Fax:731-986-0011
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018192363LF0000X
TN17891363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily