Provider Demographics
NPI:1982922928
Name:KNIGHT, P. JOE (CRNA)
Entity Type:Individual
Prefix:
First Name:P.
Middle Name:JOE
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:802 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-5705
Mailing Address - Country:US
Mailing Address - Phone:801-360-9580
Mailing Address - Fax:
Practice Address - Street 1:802 S 500 W
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-5705
Practice Address - Country:US
Practice Address - Phone:801-360-9580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT267337-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered