Provider Demographics
NPI:1093398893
Name:KNESS-KNEZINSKIS, ERIKA KRALL (MD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:KRALL
Last Name:KNESS-KNEZINSKIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:MARGARET
Other - Last Name:KRALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 245058
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5058
Mailing Address - Country:US
Mailing Address - Phone:520-626-7747
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE RM 4334
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-7747
Practice Address - Fax:520-626-2247
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR78620208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery