Provider Demographics
NPI:1609803683
Name:KIGHT, JEANNETTE (MSN, RN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:
Last Name:KIGHT
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 CATTLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1901
Mailing Address - Country:US
Mailing Address - Phone:210-410-9477
Mailing Address - Fax:
Practice Address - Street 1:MHM SBHC
Practice Address - Street 2:217 WEST OTTO ST
Practice Address - City:MARION
Practice Address - State:TX
Practice Address - Zip Code:78124
Practice Address - Country:US
Practice Address - Phone:830-914-2803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664471363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics