Julie Noelle Knisely, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN277201 Issued in GA

Practice address

5582 Memorial Dr
Stone Mountain, GA 30083-3215

Phone

(404) 298-8998

NPI assigned

Jan 12, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Julie Mitterholzer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1033708441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 PROFESSIONAL PKWY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5582 MEMORIAL DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833215",
            "telephone_number": "404-298-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNISELY",
        "first_name": "JULIE",
        "middle_name": "NOELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN277201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "MITTERHOLZER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Cody J Klein, PT, DPT, M.ED
• Corey Edward Klein, PT, DPT
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• Family Nurse Practitioner in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.