Healthcare Provider Details

I. General information

NPI: 1245156769
Provider Name (Legal Business Name): BLAKE AARON KNIGHTON BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3489 E BASELINE RD
GILBERT AZ
85234-2651
US

IV. Provider business mailing address

35268 N BREEZY LN
SAN TAN VALLEY AZ
85140-0194
US

V. Phone/Fax

Practice location:
  • Phone: 480-542-1212
  • Fax:
Mailing address:
  • Phone: 480-826-4312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: