Healthcare Provider Details

I. General information

NPI: 1871586891
Provider Name (Legal Business Name): JENNIFER THORNELL RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER KNIGHTS RPA-C

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HURLEY AVE STE 10
KINGSTON NY
12401-3738
US

IV. Provider business mailing address

969 MAIN ST STE D
FISHKILL NY
12524-1791
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-3200
  • Fax: 845-338-3233
Mailing address:
  • Phone: 845-896-7730
  • Fax: 845-896-7758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number007682
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number007682
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: