MEDICARE: CATHARINA KNUTSEN

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	183500000X	Pharmacist	15293	NV

General Provider Information

NPI Number	:	1770188823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHARINA KNUTSEN

Provider Business Mailing Address
First Line	:	8005 S VIRGINIA ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-8940
Country	:	US
Telephone Number	:	775-853-7555
Fax Number	:	775-853-7583

Provider Business Practice Location Address
First Line	:	8005 S VIRGINIA ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-8940
Country	:	US
Telephone Number	:	775-853-7555
Fax Number	:	775-853-7583

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

Provider Enumeration Date	:	12/04/2020
Last Update Date	:	12/04/2020

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Directions to “ CATHARINA KNUTSEN ” Practice Location

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