Provider Demographics
NPI:1407599954
Name:KNIGHT, KARISA DANIELLE
Entity Type:Individual
Prefix:
First Name:KARISA
Middle Name:DANIELLE
Last Name:KNIGHT
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 1:239 VALLEY GROVE LN
Mailing Address - Street 2:
Mailing Address - City:CRAIGSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26205-9614
Mailing Address - Country:US
Mailing Address - Phone:304-619-0300
Mailing Address - Fax:
Practice Address - Street 1:4 PARK PL
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:WV
Practice Address - Zip Code:26261-1116
Practice Address - Country:US
Practice Address - Phone:304-651-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker