1083852131 NPI number — MS. SARA AILEEN KNIGHT FNP

Table of content: MS. SARA AILEEN KNIGHT FNP (NPI 1083852131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083852131 NPI number — MS. SARA AILEEN KNIGHT FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNIGHT
Provider First Name:
SARA
Provider Middle Name:
AILEEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083852131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
213 SILAS TRCE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGELAND
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39157-9743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-506-4442
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COMPERE'S NURSING HOME
Provider Second Line Business Practice Location Address:
865 NORTH ST
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-206-0901
Provider Business Practice Location Address Fax Number:
888-240-6288
Provider Enumeration Date:
01/28/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R857908 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)