Provider Demographics
NPI:1083109987
Name:KNAPP, KATHY
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GLENAIRE
Mailing Address - Street 2:4000 GLENAIRE CIRCLE
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-460-8095
Mailing Address - Fax:919-467-0844
Practice Address - Street 1:4000 GLENAIRE CIR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3884
Practice Address - Country:US
Practice Address - Phone:919-460-8095
Practice Address - Fax:919-467-0844
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3483225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist