Basic Information
Provider Information
NPI: 1780152421
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNIGHT
FirstName: AUBRY
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: MSN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1949 GUNBARREL RD STE 206
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374213188
CountryCode: US
TelephoneNumber: 4234954345
FaxNumber: 4234954934
Practice Location
Address1: 611 E VILLANOW ST
Address2:  
City: LA FAYETTE
State: GA
PostalCode: 307282618
CountryCode: US
TelephoneNumber: 7066381606
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/12/2018
LastUpdateDate: 07/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X207148GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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