Provider Demographics
NPI:1649931718
Name:KNIGHT, NICOLE (CNM)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LA CASA VIA STE 208
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3007
Mailing Address - Country:US
Mailing Address - Phone:925-935-5356
Mailing Address - Fax:925-935-1070
Practice Address - Street 1:120 LA CASA VIA STE 208
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3007
Practice Address - Country:US
Practice Address - Phone:925-935-5356
Practice Address - Fax:925-935-1070
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA714661163WE0003X
CA367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WE0003XNursing Service ProvidersRegistered NurseEmergency