Healthcare Provider Details

I. General information

NPI: 1932173127
Provider Name (Legal Business Name): DANIEL B KNIGHT N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W. PARK AVE
ASH FORK AZ
86320
US

IV. Provider business mailing address

419 S 3RD ST
WILLIAMS AZ
86046-2448
US

V. Phone/Fax

Practice location:
  • Phone: 855-277-5901
  • Fax: 833-731-0353
Mailing address:
  • Phone: 855-277-5901
  • Fax: 833-731-0353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2115
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN103251
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: