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General NPI Number Information
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NPI Number | 1750610044
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Entity Type | Individual
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Provider Name | KRISTIN NICOLE KNOBLOCH APRN-CNS
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Gender | Female
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 3 PROFESSIONAL DR STE C
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City | ALTON
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State | IL
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Zip | 62002-5011
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Country | US
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Telephone | 618-433-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 3 PROFESSIONAL DR STE C
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City | ALTON
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State | IL
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Zip | 62002-5011
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Country | US
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Telephone | 618-433-9300
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 83379
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 364SC0200X
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Taxonomy Name | Critical Care Medicine Clinical Nurse Specialist
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License Number | 2012031746
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 364SC0200X
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Taxonomy Name | Critical Care Medicine Clinical Nurse Specialist
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License Number | 83379
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 277001352
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License Number State | IL
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