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NPI Code Detail

MEDICARE: KERI L KNAACK CRNA

MEDICARE: KERI L KNAACK CRNA
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
1367500000XCertified Registered Nurse Anesthetist115369WI
2367500000XCertified Registered Nurse Anesthetist3401-33WI
3367500000XCertified Registered Nurse Anesthetist073619WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407833866
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERI L KNAACK CRNA
Provider Business Mailing Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-387-5511
Fax Number : 715-834-3087
Provider Business Practice Location Address
First Line : 2116 CRAIG RD
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54701-6118
Country : US
Telephone Number : 715-858-4610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 11/06/2025

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Directions to “ KERI L KNAACK CRNA” Practice Location

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