Healthcare Provider Details

I. General information

NPI: 1386767291
Provider Name (Legal Business Name): MONA CARTER KNIGHT F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 MEDICAL CENTER CT SUITE 7
CHULA VISTA CA
91911-6634
US

IV. Provider business mailing address

750 MEDICAL CENTER CT SUITE 7
CHULA VISTA CA
91911-6634
US

V. Phone/Fax

Practice location:
  • Phone: 619-741-3595
  • Fax: 619-656-3123
Mailing address:
  • Phone: 619-741-3595
  • Fax: 619-656-3123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberRN427651
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: