Doctor Name: | KISHA L KNIGHT |
NPI Number: | 1023319936 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | R863895 |
Business Practice Address: | 404 Lillie Burney St Hattiesburg, MS - 394015505 |
Business Phone Number: | 6014506500 |
Business Fax Number: | 6014506503 |
Mailing Address: | Po Box 1729, HATTIESBURG |
State: | MS |
Postal Code: | 394031729 |
Phone Number: | 6015453700 |
Fax Number: | 6014502493 |
NPI Enumeration Date: | 11/09/2010 |
NPI Last Update Date: | 04/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R863895 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |