Provider Demographics
NPI:1558244731
Name:KNOTT, SHANIQUE (DNP, APRN,PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHANIQUE
Middle Name:
Last Name:KNOTT
Suffix:
Gender:F
Credentials:DNP, APRN,PMHNP-BC
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 668394
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33066-8394
Mailing Address - Country:US
Mailing Address - Phone:954-625-4617
Mailing Address - Fax:
Practice Address - Street 1:2351 W ATLANTIC BLVD # 668394
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-2651
Practice Address - Country:US
Practice Address - Phone:954-625-4617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11039270363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty