Mark A Knight, RN
Individual provider Active NPI Registered Nurse · Dora, AL
NPI 1558032193 · NPPES record last updated Sep 23, 2021
Key facts
- NPI
- 1558032193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1-179505 (AL)
- Practice address
- 7363 Mill Creek Dr
Dora, AL 35062-2275 - Phone
- (205) 517-7752
- NPI assigned
- Sep 23, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-179505 | AL | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-179505 | AL | Yes |
Addresses
Primary practice location
7363 Mill Creek Dr
Dora, AL 35062-2275
Mailing address
7363 Mill Creek Dr
Dora, AL 35062-2275
Phone (205) 517-7752
Other providers in Dora, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.