Basic Information
Provider Information
NPI: 1487722344
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNIGHT
FirstName: ANITA
MiddleName: I
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 405 NC 65 PO BOX 355
Address2:  
City: WENTWORTH
State: NC
PostalCode: 27375
CountryCode: US
TelephoneNumber: 3363428316
FaxNumber: 3363428352
Practice Location
Address1: 1105 NC 65
Address2:  
City: WENTWORTH
State: NC
PostalCode: 27375
CountryCode: US
TelephoneNumber: 3363428316
FaxNumber: 3363428352
Other Information
ProviderEnumerationDate: 11/30/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X079759NCY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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