MEDICARE: LAKIERRIA SHANTE KNIGHT PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1-173248	AL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1-173248	MS

General Provider Information

NPI Number	:	1710505425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKIERRIA SHANTE KNIGHT PMHNP

Provider Business Mailing Address
First Line	:	600 SUN TEMPLE DR
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-8643
Country	:	US
Telephone Number	:	256-975-4291
Fax Number	:	256-325-1890

Provider Business Practice Location Address
First Line	:	2740 PASS RD
Second Line	:	MADISON AL 35758
City	:	BILOXI
State	:	MS
Zip	:	39531-2626
Country	:	US
Telephone Number	:	256-701-5651
Fax Number	:	256-429-9411

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

Provider Enumeration Date	:	07/09/2020
Last Update Date	:	02/12/2026

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