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NPI Code Detail

MEDICARE: DR. JENNIFER S. KNAPP D.O.

MEDICARE: DR. JENNIFER S. KNAPP D.O.
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
12084P0800XPsychiatry Physician34.009659OH
22084P0800XPsychiatry Physician02003907AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
102003907AOTHERINOSTEOPATH PHYSICIAN LICENSE
2000000727514OTHERINANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700090677
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER S. KNAPP D.O.
Provider Business Mailing Address
First Line : 3220 E JEFFERSON BLVD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46615-3028
Country : US
Telephone Number : 574-222-2466
Fax Number : 574-222-2468
Provider Business Practice Location Address
First Line : 3220 E JEFFERSON BLVD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46615-3028
Country : US
Telephone Number : 574-222-2466
Fax Number : 574-222-2468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 02/09/2018

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