Provider Demographics
NPI:1144805169
Name:KNIGHTEN, LADAWNA
Entity Type:Individual
Prefix:
First Name:LADAWNA
Middle Name:
Last Name:KNIGHTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 W EDISON ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-6022
Mailing Address - Country:US
Mailing Address - Phone:918-924-4105
Mailing Address - Fax:
Practice Address - Street 1:2818 W EDISON ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-6022
Practice Address - Country:US
Practice Address - Phone:918-924-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator