Healthcare Provider Details

I. General information

NPI: 1437262334
Provider Name (Legal Business Name): NATALEE NICOLE KNIGHT PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4913 W RENO AVE
OKLAHOMA CITY OK
73127-6339
US

IV. Provider business mailing address

820 NW 139TH ST
EDMOND OK
73013-1955
US

V. Phone/Fax

Practice location:
  • Phone: 405-948-4900
  • Fax: 405-948-4919
Mailing address:
  • Phone: 405-755-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA701
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: