MEDICARE: MRS. DIANNE KAY KNAPP ARNP

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	363LF0000X	Family Nurse Practitioner	A047738	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1184623985	OTHER	IA	MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760482426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANNE KAY KNAPP ARNP

Provider Business Mailing Address
First Line	:	509 N MADISON ST
Second Line	:
City	:	BLOOMFIELD
State	:	IA
Zip	:	52537-1271
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 N MADISON ST
Second Line	:
City	:	BLOOMFIELD
State	:	IA
Zip	:	52537-1271
Country	:	US
Telephone Number	:	641-664-3832
Fax Number	:

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	01/27/2021

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