Provider Demographics
NPI:1780865485
Name:KNIGHT, JIMMIE SUE (RN, PHN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:JIMMIE
Middle Name:SUE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:RN, PHN, IBCLC
Other - Prefix:
Other - First Name:JIMMIE
Other - Middle Name:SUE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN
Mailing Address - Street 1:15880 EL PAJARO CT
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5640
Mailing Address - Country:US
Mailing Address - Phone:408-859-1490
Mailing Address - Fax:
Practice Address - Street 1:15880 EL PAJARO CT
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5640
Practice Address - Country:US
Practice Address - Phone:408-859-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA692825163WC0400X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WC0400XNursing Service ProvidersRegistered NurseCase Management