Provider Demographics
NPI:1598406829
Name:KNIGHT, JACQUELEEN PICOU (FNP-C)
Entity Type:Individual
Prefix:
First Name:JACQUELEEN
Middle Name:PICOU
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37283 SWAMP RD STE 1202
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3229
Mailing Address - Country:US
Mailing Address - Phone:225-677-6900
Mailing Address - Fax:
Practice Address - Street 1:37283 SWAMP RD STE 1202
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3229
Practice Address - Country:US
Practice Address - Phone:225-677-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily