MEDICARE: EDDIE KNIGHT

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	374U00000X	Home Health Aide	H13348749	NE

General Provider Information

NPI Number	:	1568325306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDIE KNIGHT

Provider Business Mailing Address
First Line	:	1941 S 42ND ST STE 120
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2942
Country	:	US
Telephone Number	:	402-578-8203
Fax Number	:

Provider Business Practice Location Address
First Line	:	1941 S 42ND ST STE 120
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2942
Country	:	US
Telephone Number	:	402-578-8203
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ EDDIE KNIGHT ” Practice Location

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