Healthcare Provider Details

I. General information

NPI: 1114392263
Provider Name (Legal Business Name): AMANDA N KNIGHT R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SE 18TH AVE STE 101
OCALA FL
34471-8211
US

IV. Provider business mailing address

12109 COUNTY ROAD 103
OXFORD FL
34484-2951
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-3360
  • Fax: 352-629-4512
Mailing address:
  • Phone: 352-205-8981
  • Fax: 352-391-6498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9320050
License Number StateZZ
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9320050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: