MEDICARE: RAYLENE KNIGHT CSFA PLLC

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	246ZC0007X	Surgical Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	112783	OTHER		CSFA CERTIFICATION

General Provider Information

NPI Number	:	1689034829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAYLENE KNIGHT CSFA PLLC

Provider Business Mailing Address
First Line	:	4322 E JANICE WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-8101
Country	:	US
Telephone Number	:	508-341-5153
Fax Number	:

Provider Business Practice Location Address
First Line	:	4322 E JANICE WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-8101
Country	:	US
Telephone Number	:	508-341-5153
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAYLENE J KNIGHT
Credential	:	CSFA
Telephone Number	:	508-341-5153

Provider Enumeration Date	:	03/01/2016
Last Update Date	:	11/13/2019

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