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Individual

BRUCEALYNEA JOY KNOWLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4101 WESLEY ST STE C, GREENVILLE, TX 75401-5635
(903) 454-8111
Mailing address
4101 WESLEY ST STE C, GREENVILLE, TX 75401-5635
(903) 454-8111

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
707126
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
211527101
TX
05
211527102
TX
05
211527103
TX
Enumeration date
09/22/2009
Last updated
09/15/2010
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