Provider Demographics
NPI:1750169819
Name:MCKNIGHT, ANGELA R (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:R
Other - Last Name:MCKNIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7101 SMOKEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-6800
Mailing Address - Country:US
Mailing Address - Phone:615-719-3215
Mailing Address - Fax:
Practice Address - Street 1:7101 SMOKEY HILL RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-6800
Practice Address - Country:US
Practice Address - Phone:615-719-3215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN209171163W00000X
TN35032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse