Healthcare Provider Details

I. General information

NPI: 1477276954
Provider Name (Legal Business Name): CHAD E KNIGHT APRN FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 SW 157TH ST
MOORE OK
73170-7687
US

IV. Provider business mailing address

2400 S SANTA FE AVE APT 205
MOORE OK
73160-2825
US

V. Phone/Fax

Practice location:
  • Phone: 405-919-8787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number215249
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number215249
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number215249
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: