Provider Demographics
NPI:1508677592
Name:KNIGHT, HENRY FONTRI (CPSS)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:FONTRI
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3612 CUMING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1900
Mailing Address - Country:US
Mailing Address - Phone:402-312-5881
Mailing Address - Fax:
Practice Address - Street 1:6101 NW RADIAL HWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3353
Practice Address - Country:US
Practice Address - Phone:402-510-5801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NECPSS-172175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist