Healthcare Provider Details

I. General information

NPI: 1417863689
Provider Name (Legal Business Name): JENNIFER KNAPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 320TH ST
GOWRIE IA
50543-7546
US

IV. Provider business mailing address

1209 320TH ST
GOWRIE IA
50543-7546
US

V. Phone/Fax

Practice location:
  • Phone: 712-796-1944
  • Fax:
Mailing address:
  • Phone: 515-201-9442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number117786
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: