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General NPI Number Information
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NPI Number | 1043896400
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Entity Type | Individual
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Provider Name | LACHELLE KNIGHTON
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Gender | Female
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 17309 I 30
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City | BENTON
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State | AR
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Zip | 72015-2927
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Country | US
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Telephone | 501-778-5041
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Fax |
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Provider Business Mailing Address
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Address Line | 12 ROSEWALL LN
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City | LITTLE ROCK
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State | AR
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Zip | 72210-5778
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Country | US
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Telephone | 918-329-9142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PT03506
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License Number State | AR
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