Provider Demographics
NPI:1639777444
Name:KNIGHT, FONTA LEE (CNM)
Entity Type:Individual
Prefix:
First Name:FONTA
Middle Name:LEE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 6TH AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2627
Mailing Address - Country:US
Mailing Address - Phone:717-845-9639
Mailing Address - Fax:
Practice Address - Street 1:1600 6TH AVE STE 114
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2627
Practice Address - Country:US
Practice Address - Phone:717-845-9639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA176B00000X
PAMW010604176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife