Provider Demographics
NPI:1154332583
Name:KNIPPA, ROSE M (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:M
Last Name:KNIPPA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5309 WILLIAMS DR STE B
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4638
Mailing Address - Country:US
Mailing Address - Phone:361-991-4672
Mailing Address - Fax:361-991-4673
Practice Address - Street 1:5309 WILLIAMS DR STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4638
Practice Address - Country:US
Practice Address - Phone:361-991-4672
Practice Address - Fax:361-991-4673
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V0880OtherBCBS PROVIDER #