Provider Demographics
NPI:1871832964
Name:KNIGHT, PAMELA J (LPN II)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPN II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARE SHOALS
Mailing Address - State:SC
Mailing Address - Zip Code:29692-1440
Mailing Address - Country:US
Mailing Address - Phone:864-456-7496
Mailing Address - Fax:864-456-4470
Practice Address - Street 1:45 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WARE SHOALS
Practice Address - State:SC
Practice Address - Zip Code:29692-1440
Practice Address - Country:US
Practice Address - Phone:864-456-7496
Practice Address - Fax:864-456-4470
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP7271164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse