Provider Demographics
NPI:1427750546
Name:MCKNIGHT, ASHLEY DALE (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DALE
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 GANDERVALLEY LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-6239
Mailing Address - Country:US
Mailing Address - Phone:731-614-7339
Mailing Address - Fax:
Practice Address - Street 1:270 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2077
Practice Address - Country:US
Practice Address - Phone:731-968-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33434363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner