Provider Demographics
NPI:1245259159
Name:KNIGHT, DAVIA L (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DAVIA
Middle Name:L
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-0736
Mailing Address - Country:US
Mailing Address - Phone:620-820-5800
Mailing Address - Fax:620-820-5821
Practice Address - Street 1:116 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:CHERRYVALE
Practice Address - State:KS
Practice Address - Zip Code:67335-1729
Practice Address - Country:US
Practice Address - Phone:620-336-3255
Practice Address - Fax:620-336-3755
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00854363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSMK0910251OtherDEA NUMBER
009832Medicare PIN