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NPI Code Detail

MEDICARE: MRS. CHRISTY LEA KNIEPKAMP OT

MEDICARE: MRS. CHRISTY LEA KNIEPKAMP OT
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
1225X00000XOccupational Therapist1516NM

General Provider Information

NPI Number : 1770615817
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTY LEA KNIEPKAMP OT
Provider Business Mailing Address
First Line : 1936 PINON DUNKEN RD
Second Line :
City : PINON
State : NM
Zip : 88344-9706
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2218 W GRAND AVE
Second Line :
City : ARTESIA
State : NM
Zip : 88210-1624
Country : US
Telephone Number : 505-748-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 07/08/2007

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