Provider Demographics
NPI:1083235972
Name:KNIGHT, RAKETRA RONTRESE (PA)
Entity type:Individual
Prefix:MRS
First Name:RAKETRA
Middle Name:RONTRESE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:860 GLENWOOD AVE SE APT 223
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1994
Mailing Address - Country:US
Mailing Address - Phone:903-244-2469
Mailing Address - Fax:
Practice Address - Street 1:830 EAGLES LANDING PKWY STE 202
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7366
Practice Address - Country:US
Practice Address - Phone:707-991-2176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2025-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA11022363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical