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General NPI Number Information
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NPI Number | 1790500858
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Entity Type | Individual
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Provider Name | TAYLOR RAE KNIGHT PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 14 RICHLAND MEDICAL PARK DR STE 310
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City | COLUMBIA
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State | SC
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Zip | 29203-6883
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Country | US
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Telephone | 803-434-8450
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Fax | 803-434-0137
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE STE 300
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City | GREENVILLE
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State | SC
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Zip | 29601-2899
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Country | US
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Telephone | 864-522-8611
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5593
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License Number State | SC
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