Mattie Knight
Individual provider Active NPI Homemaker · Montgomery, AL
NPI 1568965663 · NPPES record last updated Mar 14, 2018
Key facts
- NPI
- 1568965663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- 201805057 (AL)
- Practice address
- 2400 Wentworth Dr
Montgomery, AL 36106-3239 - Phone
- (334) 419-7312
- NPI assigned
- Mar 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201805057 | AL | MD | Homemaker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | 201805057 | AL | Yes |
Addresses
Primary practice location
2400 Wentworth Dr
Montgomery, AL 36106-3239
Mailing address
2400 Wentworth Dr
Montgomery, AL 36106-3239
Phone (334) 419-7312
Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.