Basic Information
Provider Information
NPI: 1154728467
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNOX
FirstName: ANDREA
MiddleName: B
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1718 PATTERSON ST
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032926
CountryCode: US
TelephoneNumber: 6153271085
FaxNumber: 6153201948
Practice Location
Address1: 333 COMMERCE ST
Address2: STE..700
City: NASHVILLE
State: TN
PostalCode: 372011826
CountryCode: US
TelephoneNumber: 6153468468
FaxNumber: 8889724927
Other Information
ProviderEnumerationDate: 12/02/2014
LastUpdateDate: 01/30/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X19422TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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