Individual
AUTUMN A KNOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
(317) 963-0595
(317) 222-2048
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
71014611A
IN
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
71014611A
IN
363LG0600X
Gerontology Nurse Practitioner
71014611A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103779333
ANTHEM PTAN
IN
05
—
300084730
—
IN
Enumeration date
12/11/2023
Last updated
01/15/2025
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