Healthcare Provider Details

I. General information

NPI: 1285393975
Provider Name (Legal Business Name): JOANNE KNUPP R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8579 N TALLADEGA WAY
FRESNO CA
93720
US

IV. Provider business mailing address

8579 N TALLADEGA WAY
FRESNO CA
93720
US

V. Phone/Fax

Practice location:
  • Phone: 954-899-7391
  • Fax:
Mailing address:
  • Phone: 954-899-7391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number617795
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number617795
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number617795
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: