Healthcare Provider Details

I. General information

NPI: 1750630364
Provider Name (Legal Business Name): STEPHANIE A KNIGHT APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 LOOP RD STE B
WINNSBORO LA
71295-3343
US

IV. Provider business mailing address

PO BOX 4506
SHREVEPORT LA
71134-0506
US

V. Phone/Fax

Practice location:
  • Phone: 318-239-4860
  • Fax: 805-295-4715
Mailing address:
  • Phone: 318-239-4860
  • Fax: 805-295-4715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP136950
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07010
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: