MEDICARE: KARRIE L KNOPF PA-C

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	207Q00000X	Family Medicine Physician	244	WY

Other Identifiers

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

General Provider Information

NPI Number	:	1487659371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARRIE L KNOPF PA-C

Provider Business Mailing Address
First Line	:	196 ARROWHEAD DR
Second Line	:	SUITE 1
City	:	EVANSTON
State	:	WY
Zip	:	82930-8752
Country	:	US
Telephone Number	:	307-783-8123
Fax Number	:	615-465-2894

Provider Business Practice Location Address
First Line	:	196 ARROWHEAD DR
Second Line	:	STE 1
City	:	EVANSTON
State	:	WY
Zip	:	82930-8752
Country	:	US
Telephone Number	:	307-783-8123
Fax Number	:	307-783-8254

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	04/16/2008

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