MEDICARE: URSULA KNIGHT FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	901500	MS
2	363LP2300X	Primary Care Nurse Practitioner	901500	MS

General Provider Information

NPI Number	:	1124576707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	URSULA KNIGHT FNP

Provider Business Mailing Address
First Line	:	PO BOX 1810
Second Line	:
City	:	GULFPORT
State	:	MS
Zip	:	39502-1810
Country	:	US
Telephone Number	:	228-475-1166
Fax Number	:

Provider Business Practice Location Address
First Line	:	8006 HIGHWAY 613
Second Line	:
City	:	MOSS POINT
State	:	MS
Zip	:	39562-8200
Country	:	US
Telephone Number	:	228-475-1166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	10/15/2019

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