Basic Information
| Provider Information | |||||||||
| NPI: | 1184862120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNOX | ||||||||
| FirstName: | WHITNEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2206 NEEDHAM ST | ||||||||
| Address2: | APT. #4 | ||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724017209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709721268 | ||||||||
| FaxNumber: | 8709340847 | ||||||||
| Practice Location | |||||||||
| Address1: | 1217 STONE ST | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724014520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709339528 | ||||||||
| FaxNumber: | 8709339778 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2009 | ||||||||
| LastUpdateDate: | 10/03/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 373H00000X | Y | Nursing Service Related Providers | Day Training/Habilitation Specialist |
No ID Information.