Provider Demographics
NPI:1942728118
Name:KNIGHT, LYNMARIE (APRN)
Entity type:Individual
Prefix:
First Name:LYNMARIE
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 HEARST AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2112
Mailing Address - Country:US
Mailing Address - Phone:510-570-6695
Mailing Address - Fax:
Practice Address - Street 1:837 ADDISON ST.
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710
Practice Address - Country:US
Practice Address - Phone:510-981-4100
Practice Address - Fax:510-981-4294
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily