Provider Demographics
NPI:1629867262
Name:MCKNIGHT, MASON (FNP-C)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:MCKNIGHT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 SIEGEN LN STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2372
Mailing Address - Country:US
Mailing Address - Phone:225-244-8690
Mailing Address - Fax:225-615-7704
Practice Address - Street 1:8540 SIEGEN LN STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2372
Practice Address - Country:US
Practice Address - Phone:225-224-8690
Practice Address - Fax:225-615-7704
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily