Provider Demographics
NPI:1417217258
Name:KNIGHT, ROSALEE LETTIE (LPN)
Entity Type:Individual
Prefix:
First Name:ROSALEE
Middle Name:LETTIE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18704 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5811
Mailing Address - Country:US
Mailing Address - Phone:347-561-4805
Mailing Address - Fax:732-453-3828
Practice Address - Street 1:18704 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5811
Practice Address - Country:US
Practice Address - Phone:347-561-4805
Practice Address - Fax:732-453-3828
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-28
Last Update Date:2012-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309013-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse