Provider Demographics
NPI:1689281420
Name:KNIGHT, ANDREA LEIGH
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEIGH
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6834 ALKIRE RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-9143
Mailing Address - Country:US
Mailing Address - Phone:614-425-7386
Mailing Address - Fax:
Practice Address - Street 1:6834 ALKIRE RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-9143
Practice Address - Country:US
Practice Address - Phone:614-425-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH25601073747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider