Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00938300 | NJ |
NPI | 1013561190 |
---|---|
Provider Name | Ms. Danielle Knight |
First Address | Boston, MA 02241-6457 |
Second Address | Summit, NJ 07901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2019 |
Last Update Date | 28/05/2020 |