Provider Demographics
NPI:1588234603
Name:KNIGHT, ANDREA THOMAS
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:THOMAS
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 1:410 SIKES MILL RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-9756
Mailing Address - Country:US
Mailing Address - Phone:704-289-9627
Mailing Address - Fax:
Practice Address - Street 1:410 SIKES MILL RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-9756
Practice Address - Country:US
Practice Address - Phone:704-289-9627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCKNIG-7M1LJ363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily