Provider Demographics
NPI:1568550283
Name:KNIGHT, BRANDI D (FNP)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:D
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1930 BRANNAN RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4310
Mailing Address - Country:US
Mailing Address - Phone:678-284-4040
Mailing Address - Fax:678-284-4076
Practice Address - Street 1:970 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:SUITE 260
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2159
Practice Address - Country:US
Practice Address - Phone:770-607-1893
Practice Address - Fax:770-607-2930
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN143310NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBJNFMedicare PIN
GAQ48390Medicare UPIN