Provider Demographics
NPI:1558009464
Name:KNIGHT, KACHINA MACHELLE
Entity Type:Individual
Prefix:
First Name:KACHINA
Middle Name:MACHELLE
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 1:3573 EARLYNN DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2735
Mailing Address - Country:US
Mailing Address - Phone:901-634-8695
Mailing Address - Fax:
Practice Address - Street 1:3573 EARLYNN DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-2735
Practice Address - Country:US
Practice Address - Phone:901-634-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN153738163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse