Provider Demographics
NPI:1588311849
Name:MCKNIGHT, ERICA NANNETTE (CSFA)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:NANNETTE
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15401
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-5401
Mailing Address - Country:US
Mailing Address - Phone:678-463-5140
Mailing Address - Fax:
Practice Address - Street 1:6953 STONE BREEZE DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-4525
Practice Address - Country:US
Practice Address - Phone:678-463-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant