Healthcare Provider Details

I. General information

NPI: 1841206596
Provider Name (Legal Business Name): JANICE EMMA KNOEFEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 MCMAHON BLVD NW WESTSIDE FAMILY - SENIOR HEALTH CENTER
ALBUQUERQUE NM
87114-5010
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-1754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number96-303
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: