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General NPI Number Information
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NPI Number | 1174060107
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Entity Type | Individual
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Provider Name | MRS. LAURIE LEE KNAPP
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Gender | Female
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Dates
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Enumeration Date | 01/29/2017
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 8155 BLACKMAN RD
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City | KINGSLEY
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State | MI
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Zip | 49649-9405
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Country | US
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Telephone | 231-263-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 8155 BLACKMAN RD
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City | KINGSLEY
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State | MI
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Zip | 49649-9405
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Country | US
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Telephone | 231-263-0058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | AF280311047
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License Number State | MI
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