Provider Demographics
NPI:1780022954
Name:KNIGHT, BRYAN JAMES (LPN)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:JAMES
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 KITTLE RD
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8783
Mailing Address - Country:US
Mailing Address - Phone:740-370-2025
Mailing Address - Fax:
Practice Address - Street 1:1062 KITTLE RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8783
Practice Address - Country:US
Practice Address - Phone:740-370-2025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150919164W00000X
WV33168164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse