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General NPI Number Information
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NPI Number | 1407906373
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Entity Type | Individual
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Provider Name | ANDREA FORTSON KNOPP FNP
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 934 N AUGUSTA ST
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City | STAUNTON
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State | VA
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Zip | 24401-3215
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Country | US
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Telephone | 540-885-6789
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 MIDDLEBROOK AVE
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City | STAUNTON
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State | VA
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Zip | 24401-4545
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Country | US
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Telephone | 540-294-3238
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024167074
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License Number State | VA
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