Healthcare Provider Details

I. General information

NPI: 1548557564
Provider Name (Legal Business Name): DIANE G KNAPIC APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MAINE ST
LAWRENCE KS
66044-1368
US

IV. Provider business mailing address

200 MAINE ST
LAWRENCE KS
66044-1368
US

V. Phone/Fax

Practice location:
  • Phone: 785-832-8192
  • Fax:
Mailing address:
  • Phone: 785-832-8192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number74080
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: