Provider Demographics
NPI:1508185133
Name:KNIGHT, REBECCA ANNE (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 CHADWICK DR STE 298
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3234
Mailing Address - Country:US
Mailing Address - Phone:615-750-3774
Mailing Address - Fax:
Practice Address - Street 1:238 CENTRE ST STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146
Practice Address - Country:US
Practice Address - Phone:615-746-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN14949363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518413Medicaid