Provider Demographics
NPI:1629839428
Name:KNIGHT, BILLY RAY JR (RN)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:RAY
Last Name:KNIGHT
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:BILLY
Other - Middle Name:RAY
Other - Last Name:KNIGHT
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:707 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 SOUTHVIEW DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4244
Practice Address - Country:US
Practice Address - Phone:561-951-6335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9526653163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health