Healthcare Provider Details

I. General information

NPI: 1477464865
Provider Name (Legal Business Name): CHRISTINE KNACK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 CAMBRIDGE ST
TOLEDO OH
43610-1159
US

IV. Provider business mailing address

3131 CAMBRIDGE ST
TOLEDO OH
43610-1159
US

V. Phone/Fax

Practice location:
  • Phone: 419-671-4700
  • Fax: 419-671-4745
Mailing address:
  • Phone: 419-671-4700
  • Fax: 419-671-4745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN250183
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: