Provider Demographics
NPI:1841730363
Name:KNOTH, LORI NICOLE (CNM)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:NICOLE
Last Name:KNOTH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:59 US HIGHWAY 46
Mailing Address - Street 2:#300
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2695
Mailing Address - Country:US
Mailing Address - Phone:908-509-1801
Mailing Address - Fax:732-301-9252
Practice Address - Street 1:57 US HIGHWAY 46
Practice Address - Street 2:STE 300
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2695
Practice Address - Country:US
Practice Address - Phone:908-509-1801
Practice Address - Fax:732-301-9252
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25ME00061401367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife