Provider Demographics
NPI:1487274064
Name:MCRAE-KNIGHT, J'AUNIE Y
Entity type:Individual
Prefix:
First Name:J'AUNIE
Middle Name:Y
Last Name:MCRAE-KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2037 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3314
Mailing Address - Country:US
Mailing Address - Phone:601-215-9780
Mailing Address - Fax:
Practice Address - Street 1:2037 MLK JR DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3314
Practice Address - Country:US
Practice Address - Phone:601-215-9780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator