Provider Demographics
NPI:1225587660
Name:KNECHT, KATIE JENNINGS (RN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:JENNINGS
Last Name:KNECHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 WAGONTOWN RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-5944
Mailing Address - Country:US
Mailing Address - Phone:610-383-6483
Mailing Address - Fax:
Practice Address - Street 1:410 BOOT RD
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3405
Practice Address - Country:US
Practice Address - Phone:610-873-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN503224L163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health