Provider Demographics
NPI:1093315236
Name:KNOTT, STEVEN JON (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JON
Last Name:KNOTT
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190930
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83719-0930
Mailing Address - Country:US
Mailing Address - Phone:208-367-5170
Mailing Address - Fax:208-367-5180
Practice Address - Street 1:6348 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8732
Practice Address - Country:US
Practice Address - Phone:208-302-0900
Practice Address - Fax:208-302-0955
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP61127674363LP0808X
OR202011153NP-PP363LP0808X
ID2671357363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health