Healthcare Provider Details

I. General information

NPI: 1235205071
Provider Name (Legal Business Name): BARBARA ANN KNAPP-COLSTON ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22921 TRITON WAY SUITE 125
LAGUNA HILLS CA
92653-1236
US

IV. Provider business mailing address

30062 RUNNING DEER LN
LAGUNA NIGUEL CA
92677-2023
US

V. Phone/Fax

Practice location:
  • Phone: 949-366-1053
  • Fax:
Mailing address:
  • Phone: 949-495-9125
  • Fax: 949-495-6985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number339965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: