Healthcare Provider Details

I. General information

NPI: 1396709200
Provider Name (Legal Business Name): ANDREA P KNAPP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 WAKARUSA DR STE A3
LAWRENCE KS
66049-3889
US

IV. Provider business mailing address

1201 WAKARUSA DR STE A3
LAWRENCE KS
66049-3889
US

V. Phone/Fax

Practice location:
  • Phone: 785-856-6170
  • Fax: 785-856-6171
Mailing address:
  • Phone: 785-856-6170
  • Fax: 785-856-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number55037
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: