Provider Demographics
NPI:1689034829
Name:RAYLENE KNIGHT CSFA PLLC
Entity Type:Organization
Organization Name:RAYLENE KNIGHT CSFA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYLENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:508-341-5153
Mailing Address - Street 1:4322 E JANICE WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-8101
Mailing Address - Country:US
Mailing Address - Phone:508-341-5153
Mailing Address - Fax:
Practice Address - Street 1:4322 E JANICE WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-8101
Practice Address - Country:US
Practice Address - Phone:508-341-5153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
112783OtherCSFA CERTIFICATION