Provider Demographics
NPI:1194849380
Name:KNAPP, KRISTIE L (APRN-BC)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:L
Last Name:KNAPP
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:NORRIDGEWOCK
Mailing Address - State:ME
Mailing Address - Zip Code:04957-3952
Mailing Address - Country:US
Mailing Address - Phone:207-634-1250
Mailing Address - Fax:207-634-2659
Practice Address - Street 1:20 DEPOT ST
Practice Address - Street 2:
Practice Address - City:NORRIDGEWOCK
Practice Address - State:ME
Practice Address - Zip Code:04957-3952
Practice Address - Country:US
Practice Address - Phone:207-634-1250
Practice Address - Fax:207-634-2659
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1194849380Medicaid
ME1194849380Medicaid