Provider Demographics
NPI:1164832234
Name:KNIGHT, KATHY (PHD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-4310
Mailing Address - Country:US
Mailing Address - Phone:661-816-7692
Mailing Address - Fax:
Practice Address - Street 1:110 LENOIR HALL
Practice Address - Street 2:UNIVERSITY OF MS
Practice Address - City:UNIVERSITY
Practice Address - State:MS
Practice Address - Zip Code:38677
Practice Address - Country:US
Practice Address - Phone:662-915-8662
Practice Address - Fax:662-915-8663
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD0206133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered