Provider Demographics
NPI:1801176334
Name:KNOWLES, AMY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 OAKLEAF PLANTATION PKWY
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-3623
Mailing Address - Country:US
Mailing Address - Phone:904-282-1137
Mailing Address - Fax:904-282-7655
Practice Address - Street 1:1091 OAKLEAF PLANTATION PKWY
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-3623
Practice Address - Country:US
Practice Address - Phone:904-282-1137
Practice Address - Fax:904-282-7655
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60017390183500000X
FLPS45465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist