Healthcare Provider Details

I. General information

NPI: 1669418349
Provider Name (Legal Business Name): JAMES KNIGHT APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 01/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E 8TH AVE SUITE N203
DURANGO CO
81301-5708
US

IV. Provider business mailing address

270 E 8TH AVE SUITE N203
DURANGO CO
81301-5708
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-0640
  • Fax: 877-543-5916
Mailing address:
  • Phone: 970-247-0640
  • Fax: 877-543-5916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number123256
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: