Provider Demographics
NPI:1043283815
Name:KNAPP, RENEE M (DO)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:KNAPP
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:N17 W24100 RIVERWOOD DRIVE
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES, INC.
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1177
Mailing Address - Country:US
Mailing Address - Phone:262-928-4100
Mailing Address - Fax:262-928-5835
Practice Address - Street 1:13900 W NATIONAL AVENUE
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES, INC.
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151
Practice Address - Country:US
Practice Address - Phone:262-928-4500
Practice Address - Fax:262-928-4550
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI44476207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43498900Medicaid
WI683750638Medicare PIN
WIH66898Medicare UPIN
WI001768650Medicare PIN