Healthcare Provider Details

I. General information

NPI: 1306357124
Provider Name (Legal Business Name): MARTA ARAUJO KNAPP FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTA OTAVIO DE ARAUJO

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 10/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5981 FAR HILLS AVE
DAYTON OH
45429-2211
US

IV. Provider business mailing address

419 DONINGTON DR
DAYTON OH
45449-2124
US

V. Phone/Fax

Practice location:
  • Phone: 937-428-6702
  • Fax:
Mailing address:
  • Phone: 37-545-3834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number021348
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: