Healthcare Provider Details

I. General information

NPI: 1194791749
Provider Name (Legal Business Name): KATHERINE L KNAPP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 NE TUDOR RD
LEES SUMMIT MO
64086-5696
US

IV. Provider business mailing address

609 NE REED XING
LEES SUMMIT MO
64086-5584
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-0303
  • Fax:
Mailing address:
  • Phone: 816-525-9342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number119817
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: