MEDICARE: LINDA J KNAPP MD

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	2080A0000X	Pediatric Adolescent Medicine Physician	36027	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1226436	OTHER	MN	MEDICA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1226435	OTHER	MN	MEDICA
4	CP9090577009	OTHER	MN	PREFERRED ONE
5	299L5KN	OTHER	MN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1508850561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA J KNAPP MD

Provider Business Mailing Address
First Line	:	3555 WILLOW LK BLVD
Second Line	:	SUITE 140
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110
Country	:	US
Telephone Number	:	651-770-2124
Fax Number	:	651-770-3701

Provider Business Practice Location Address
First Line	:	3555 WILLOW LK BLVD
Second Line	:	SUITE 140
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110
Country	:	US
Telephone Number	:	651-770-2124
Fax Number	:	651-770-3701

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	09/06/2016

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Directions to “ LINDA J KNAPP MD” Practice Location

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