Individual
JESSICA KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
840 PINE ST, STE 900, MACON, GA 31201-2100
(478) 633-8060
(478) 633-4080
Mailing address
840 PINE ST STE 900, MACON, GA 31201-7500
(478) 633-8060
(478) 633-4080
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN209049
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003177341A
—
GA
01
—
202506I639
GA MEDICARE PTAN
GA
Enumeration date
05/07/2016
Last updated
07/16/2016
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