Provider Demographics
NPI:1952581381
Name:MCKNIGHT, MAUREAN ANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MAUREAN
Middle Name:ANNE
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MAUREAN
Other - Middle Name:ANNE
Other - Last Name:HECHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19825 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2627
Mailing Address - Country:US
Mailing Address - Phone:818-340-3636
Mailing Address - Fax:818-340-9241
Practice Address - Street 1:19825 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2627
Practice Address - Country:US
Practice Address - Phone:818-340-3636
Practice Address - Fax:818-340-9241
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA11844363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical