Provider Demographics
NPI:1245837178
Name:KNIGHT, KRYSTAL (LPN)
Entity type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:
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 1:724 DARROW DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-8073
Mailing Address - Country:US
Mailing Address - Phone:615-604-1301
Mailing Address - Fax:
Practice Address - Street 1:800 S BROWN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2920
Practice Address - Country:US
Practice Address - Phone:615-384-4504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN85768164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse