Individual
MRS. CARMEN M KNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1926 WOODLAND LAKE PASS, FORT WAYNE, IN 46825-7210
(661) 565-5368
Mailing address
1926 WOODLAND LAKE PASS, FORT WAYNE, IN 46825-7210
(661) 565-5368
(260) 755-0552
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2114
PR
332100000X
Department of Veterans Affairs (VA) Pharmacy
91225
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26023926A
STATE LICENSE
IN
Enumeration date
05/11/2009
Last updated
07/22/2020
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