Provider Demographics
NPI:1528005758
Name:MCKNIGHT, DEBORAH S (NP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:S
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:729 GRAPEVINE HWY
Mailing Address - Street 2:SUITE 387
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2805
Mailing Address - Country:US
Mailing Address - Phone:817-770-7805
Mailing Address - Fax:877-214-8747
Practice Address - Street 1:729 GRAPEVINE HWY
Practice Address - Street 2:SUITE 387
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2805
Practice Address - Country:US
Practice Address - Phone:817-770-7805
Practice Address - Fax:877-214-8747
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX531803363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health