Individual
JOSHUA DAVID KNICKERBOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 926-2544
Mailing address
3544 LANDY LN, RICHLAND HILLS, TX 76118-5949
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1225744
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
881627
TX
Other
Enumeration date
11/18/2025
Last updated
01/27/2026
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