Provider Demographics
NPI:1467140483
Name:MCKNIGHT, SHAMEKA (CRNP)
Entity Type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 GARRISON BLVD STE 100A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-2308
Mailing Address - Country:US
Mailing Address - Phone:443-762-5343
Mailing Address - Fax:833-258-3941
Practice Address - Street 1:2300 GARRISON BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2308
Practice Address - Country:US
Practice Address - Phone:443-762-5343
Practice Address - Fax:833-258-3941
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR213338363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner