MEDICARE: BROOKE KNAPP AGPCNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	A005739	AR

General Provider Information

NPI Number	:	1134705916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE KNAPP AGPCNP

Provider Business Mailing Address
First Line	:	2102 BISCAYNE DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-3936
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2102 BISCAYNE DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-3936
Country	:	US
Telephone Number	:	501-425-7605
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2021
Last Update Date	:	12/10/2025

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