Provider Demographics
NPI:1215549068
Name:KNIGHT, OLIVIA ROSE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ROSE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2884
Mailing Address - Country:US
Mailing Address - Phone:978-686-0090
Mailing Address - Fax:
Practice Address - Street 1:34 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2884
Practice Address - Country:US
Practice Address - Phone:978-686-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN5111133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered