Healthcare Provider Details

I. General information

NPI: 1437415353
Provider Name (Legal Business Name): MELISSA LYNNE KNIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPT 0861
DENVER CO
80256-0882
US

IV. Provider business mailing address

2635 N 7TH ST
GRAND JUNCTION CO
81501-8209
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-1977
  • Fax:
Mailing address:
  • Phone: 970-244-2551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number54850
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: