Provider Demographics
NPI:1851613384
Name:KNIGHT, JEANNE ENID (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:ENID
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 40131
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87196-0131
Mailing Address - Country:US
Mailing Address - Phone:505-409-1359
Mailing Address - Fax:888-544-2758
Practice Address - Street 1:3695 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-9549
Practice Address - Country:US
Practice Address - Phone:505-454-2485
Practice Address - Fax:505-454-2222
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1218103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist