Provider Demographics
NPI:1508468398
Name:KNIGHT, JENNIFER M (RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 MEADOW WOOD RD
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-8958
Mailing Address - Country:US
Mailing Address - Phone:256-504-9127
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1198
Practice Address - Country:US
Practice Address - Phone:256-492-7407
Practice Address - Fax:256-492-7396
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist