Provider Demographics
NPI:1962201806
Name:KNOWLTON, ANNA CLAIRE (NP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CLAIRE
Last Name:KNOWLTON
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 1:307 THORNTREE LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8197
Mailing Address - Country:US
Mailing Address - Phone:770-548-0763
Mailing Address - Fax:
Practice Address - Street 1:307 THORNTREE LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8197
Practice Address - Country:US
Practice Address - Phone:770-548-0763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN323997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner