Healthcare Provider Details

I. General information

NPI: 1083526586
Provider Name (Legal Business Name): KAREN TARA KNIGHT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEALTH PARK BLVD
ST AUGUSTINE FL
32086-5784
US

IV. Provider business mailing address

3268 MILLPOND CT
ORANGE PARK FL
32065-2259
US

V. Phone/Fax

Practice location:
  • Phone: 912-667-6328
  • Fax:
Mailing address:
  • Phone: 912-667-6328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberAPRN11046201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: