Provider Demographics
NPI:1912719840
Name:KNOX, CHARITY JANE (NP)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:JANE
Last Name:KNOX
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:OROVADA
Mailing Address - State:NV
Mailing Address - Zip Code:89425-0192
Mailing Address - Country:US
Mailing Address - Phone:702-279-1672
Mailing Address - Fax:
Practice Address - Street 1:980 PLACER ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1126
Practice Address - Country:US
Practice Address - Phone:530-246-5705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95171797363L00000X
NVRN69071363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner