Provider Demographics
NPI:1639958044
Name:KNIGHTON, JACEE D (FNP-C)
Entity Type:Individual
Prefix:
First Name:JACEE
Middle Name:D
Last Name:KNIGHTON
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 1:1111 N NAGLE ST
Mailing Address - Street 2:
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101-3840
Mailing Address - Country:US
Mailing Address - Phone:530-708-8820
Mailing Address - Fax:530-233-2830
Practice Address - Street 1:1111 N NAGLE ST
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-3840
Practice Address - Country:US
Practice Address - Phone:530-708-8820
Practice Address - Fax:530-233-2830
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95027047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily