MEDICARE: REBEKAH LYNN KNAUSE

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	171100000X	Acupuncturist	370	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27-18022508	OTHER	TN	SOLE PROPRIETOR

General Provider Information

NPI Number	:	1639732746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH LYNN KNAUSE

Provider Business Mailing Address
First Line	:	5801 DODGE RD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-4506
Country	:	US
Telephone Number	:	865-207-9588
Fax Number	:

Provider Business Practice Location Address
First Line	:	6712 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-4831
Country	:	US
Telephone Number	:	865-888-5342
Fax Number	:

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

Provider Enumeration Date	:	04/16/2019
Last Update Date	:	06/11/2019

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