Provider Demographics
NPI:1699864769
Name:KNIGHT, ADA PEARL (PHD, RD, LN)
Entity type:Individual
Prefix:MS
First Name:ADA
Middle Name:PEARL
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:PHD, RD, LN
Other - Prefix:MS
Other - First Name:ADA
Other - Middle Name:ROBERSON
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1916 PATTERSON ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2120
Mailing Address - Country:US
Mailing Address - Phone:615-297-1982
Mailing Address - Fax:615-272-1712
Practice Address - Street 1:1916 PATTERSON ST
Practice Address - Street 2:SUITE 505
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2120
Practice Address - Country:US
Practice Address - Phone:615-297-1982
Practice Address - Fax:615-272-1712
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLN0000001012133N00000X
TN521055133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1512102Medicaid