Healthcare Provider Details

I. General information

NPI: 1265601074
Provider Name (Legal Business Name): RHONDA KNAPP-CLEVENGER APRN BC PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 BARRES ST
STRASBURG CO
80136-8059
US

IV. Provider business mailing address

1835 BARRES ST
STRASBURG CO
80136-8059
US

V. Phone/Fax

Practice location:
  • Phone: 720-936-1242
  • Fax:
Mailing address:
  • Phone: 720-936-1242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number116983
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: