Doctor Name: | JOHN T. KNOBLOCK |
NPI Number: | 1497722540 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | AP325 |
Business Practice Address: | 1852 N Mastick Way Mariposa Community Health Center Nogales, AZ - 856211063 |
Business Phone Number: | 5202811550 |
Business Fax Number: | 5202811112 |
Mailing Address: | 1852 N Mastick Way, Mariposa Community Health Center NOGALES |
State: | AZ |
Postal Code: | 856211063 |
Phone Number: | 5202811550 |
Fax Number: | 5202811112 |
NPI Enumeration Date: | 03/07/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP325 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |