Keyly McMahon Knechtel, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30704 Issued in TN

Practice address

2269 Wilma Rudolph Blvd Ste 106
Clarksville, TN 37040-8416

Phone

(931) 542-9010

NPI assigned

Nov 13, 2021

Last updated

Apr 9, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1636761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1326704305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 OLD RUSSELLVILLE PIKE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408416",
            "telephone_number": "931-542-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 WILMA RUDOLPH BLVD STE 106",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408416",
            "telephone_number": "931-542-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNECHTEL",
        "first_name": "KEYLY",
        "middle_name": "MCMAHON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-13",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Paul Klocek
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• Family Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.