Provider Demographics
NPI:1467213256
Name:KNIGHT, JONELLE
Entity Type:Individual
Prefix:
First Name:JONELLE
Middle Name:
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 1:2902 N 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3722
Mailing Address - Country:US
Mailing Address - Phone:402-708-9587
Mailing Address - Fax:
Practice Address - Street 1:1601 N 73RD ST APT 6
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-1913
Practice Address - Country:US
Practice Address - Phone:402-266-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare