Healthcare Provider Details

I. General information

NPI: 1205779782
Provider Name (Legal Business Name): CHIKERE MCKNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR STE W214
PALM SPRINGS CA
92262-4857
US

IV. Provider business mailing address

PO BOX 19406
BELFAST ME
04915-4089
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number68400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: