Provider Demographics
NPI:1053648329
Name:HECHANOVA-KNIPSCHILD, GEMMA (NP, APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:GEMMA
Middle Name:
Last Name:HECHANOVA-KNIPSCHILD
Suffix:
Gender:F
Credentials:NP, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 HILL DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2838
Mailing Address - Country:US
Mailing Address - Phone:818-445-1096
Mailing Address - Fax:818-547-1097
Practice Address - Street 1:421 HILL DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-2838
Practice Address - Country:US
Practice Address - Phone:818-445-1096
Practice Address - Fax:818-547-1097
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-07
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN493554363L00000X
CANP9211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner