MEDICARE: MRS. KRISTIN MARIE MCKNIGHT APRN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WI0500X	Infusion Therapy Registered Nurse	RN97259	NV
2	163WG0000X	General Practice Registered Nurse	95241390	CA
3	163WM0705X	Medical-Surgical Registered Nurse	95241390	CA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95241390	CA

General Provider Information

NPI Number	:	1346949625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN MARIE MCKNIGHT APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	441 GOLD SUNRISE LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3915
Country	:	US
Telephone Number	:	281-900-8195
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 GOLD SUNRISE LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3915
Country	:	US
Telephone Number	:	281-900-8195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	01/12/2026

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