Provider Demographics
NPI:1184160376
Name:KNOX, KELLY (FNP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:KNOX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 ATLANTIC AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-9116
Mailing Address - Country:US
Mailing Address - Phone:302-745-7050
Mailing Address - Fax:
Practice Address - Street 1:38857 BENNETT AVE
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-4456
Practice Address - Country:US
Practice Address - Phone:302-947-8388
Practice Address - Fax:833-466-1834
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0049739163W00000X
DELG-0012063363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily