Healthcare Provider Details

I. General information

NPI: 1174370688
Provider Name (Legal Business Name): JIHAN ALIZA KNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9187 CENTRAL AVE
CAPITOL HEIGHTS MD
20743-3806
US

IV. Provider business mailing address

9187 CENTRAL AVE
CAPITOL HEIGHTS MD
20743-3806
US

V. Phone/Fax

Practice location:
  • Phone: 240-521-6489
  • Fax:
Mailing address:
  • Phone: 240-521-6489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: