Healthcare Provider Details

I. General information

NPI: 1316495443
Provider Name (Legal Business Name): LAUREN L KNIPE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN L RICE PA-C

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 OSTRUM ST STE 504
FOUNTAIN HILL PA
18015-1153
US

IV. Provider business mailing address

701 OSTRUM ST SUITE 302
FOUNTAIN HILL PA
18015-1155
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-3648
  • Fax: 484-526-2034
Mailing address:
  • Phone: 484-526-6000
  • Fax: 484-526-9410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA058482
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: