| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KATHARINE MELDRUM KNICELY | 1881907624 | 2023-11-10 |
Katharine Meldrum Knicely is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1881907624. Registration indicates Katharine Meldrum Knicely is a provider of services with a specialization in Specialist (Other Service Providers, Specialist) (All Other Specialties & Provider Types, ) (Specialist, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Katharine Meldrum Knicely OTR |
| Practice Office Address | 416 BRAEMAR RD SHREVEPORT, LA US |
| Practice Office Telephone | 3183933360 |
| Mailing Address | PO BOX 6357 SHREVEPORT, LA 711366357 US |
| Code | Practice | License No State |
|---|---|---|
| 174400000X PRIMARY | Specialist Other Service Providers Specialist All Other Specialties & Provider Types Specialist Other Service Providers | OTT.200401
LA |