Individual
JERAD H KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
554 W SUNNYSLOPE DR, PAUL, ID 83347-8791
(208) 534-1702
Mailing address
2732 ROCKY RD, BURLEY, ID 83318-3330
(208) 534-1702
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
64373
ID
363LF0000X
Family Nurse Practitioner
Primary
TEMP64373
ID
Other
Enumeration date
10/19/2023
Last updated
03/12/2024
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