Organization
KNW MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE N WILLINGHAM APRN (APRN)
(772) 785-9419
Entity
Organization
Contact information
Practice address
2151 SW BARTHEL ST, PORT SAINT LUCIE, FL 34984-4301
(772) 785-9419
(772) 785-9419
Mailing address
2151 SW BARTHEL ST, PORT SAINT LUCIE, FL 34984-4301
(772) 785-9419
(772) 785-9419
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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