Healthcare Provider Details

I. General information

NPI: 1386886695
Provider Name (Legal Business Name): KIRK FRANCIS KNECHT ANP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 SUMMER MORNING CT
LAFAYETTE LA
70508-7216
US

IV. Provider business mailing address

203 SUMMER MORNING CT
LAFAYETTE LA
70508-7216
US

V. Phone/Fax

Practice location:
  • Phone: 337-852-8878
  • Fax: 337-856-1465
Mailing address:
  • Phone: 337-852-8878
  • Fax: 337-856-1465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP05762
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: