Provider Demographics
NPI:1962928911
Name:KNOWLES-MOYE, CHANTEL KATHRYN (NP)
Entity type:Individual
Prefix:MRS
First Name:CHANTEL
Middle Name:KATHRYN
Last Name:KNOWLES-MOYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 DREWRY RD STE B
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460-2839
Mailing Address - Country:US
Mailing Address - Phone:251-575-5988
Mailing Address - Fax:
Practice Address - Street 1:1075 DREWRY RD STE B
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-2839
Practice Address - Country:US
Practice Address - Phone:251-575-5988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-097962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily