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General NPI Number Information
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NPI Number | 1437927241
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Entity Type | Individual
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Provider Name | CARLIE BETH KNUTSON PA
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Gender | Female
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 709 W MAIN ST
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City | MANCHESTER
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State | IA
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Zip | 52057-1526
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Country | US
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Telephone | 563-927-3232
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Fax | 563-927-7486
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Provider Business Mailing Address
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Address Line | 2117 220TH ST
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City | VENTURA
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State | IA
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Zip | 50482-8905
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Country | US
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Telephone | 641-430-3677
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 124398
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License Number State | IA
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