MEDICARE: REBECCA KNIPP NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	759053	NY
2	363LF0000X	Family Nurse Practitioner	355685	NY

General Provider Information

NPI Number	:	1104646322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KNIPP NP

Provider Business Mailing Address
First Line	:	995 SENATOR KEATING BLVD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2775
Country	:	US
Telephone Number	:	585-602-1050
Fax Number	:

Provider Business Practice Location Address
First Line	:	995 SENATOR KEATING BLVD
Second Line	:	BUILDING E, SUITE 200
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2776
Country	:	US
Telephone Number	:	585-602-1050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	03/26/2025

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