Provider Demographics
NPI:1679230908
Name:KNIGHT, JANETTE VICTORIA (RN)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:VICTORIA
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16971 GLENMORE
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2703
Mailing Address - Country:US
Mailing Address - Phone:313-412-1526
Mailing Address - Fax:
Practice Address - Street 1:16971 GLENMORE
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2703
Practice Address - Country:US
Practice Address - Phone:313-412-1526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704240744163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis