Provider Demographics
NPI:1083496418
Name:KNIGHT, ADREAN (FNP)
Entity Type:Individual
Prefix:
First Name:ADREAN
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MAEGAN PL APT 5
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2776
Mailing Address - Country:US
Mailing Address - Phone:336-508-0495
Mailing Address - Fax:
Practice Address - Street 1:50 MAEGAN PL APT 5
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2776
Practice Address - Country:US
Practice Address - Phone:336-508-0495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025760363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner