Provider Demographics
NPI:1649470345
Name:KNIGHTS, HERLINE A (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:HERLINE
Middle Name:A
Last Name:KNIGHTS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 EASTVIEW PKWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-5712
Mailing Address - Country:US
Mailing Address - Phone:678-616-1197
Mailing Address - Fax:678-616-1199
Practice Address - Street 1:80 TRILLIUM TER
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-7335
Practice Address - Country:US
Practice Address - Phone:443-992-1041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003260133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered