=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790586600
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KNAPP PSYCHIATRIC SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2025
-----------------------------------------------------
Last Update Date | 04/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1918 N PECKHAM ST
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67230-1769
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-993-5942
-----------------------------------------------------
Fax | 316-993-5942
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1918 N PECKHAM ST
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67230-1769
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-993-5942
-----------------------------------------------------
Fax | 316-993-5942
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIC NURSE PRACTITIONER, CEO
-----------------------------------------------------
Name | HAYLEY LOREE KNAPP
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 316-993-5942
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------