Provider Demographics
NPI:1902209158
Name:KNIGHT, RYAN MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RYAN
Middle Name:MARIE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 CLYDE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-1888
Mailing Address - Country:US
Mailing Address - Phone:440-361-1911
Mailing Address - Fax:
Practice Address - Street 1:1820 CLYDE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-1888
Practice Address - Country:US
Practice Address - Phone:440-361-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN155467-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse