Provider Demographics
NPI:1225624141
Name:KNAPPENBERGER, LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KNAPPENBERGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 MEIXSELL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAYLORSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18353-7309
Mailing Address - Country:US
Mailing Address - Phone:570-350-8401
Mailing Address - Fax:
Practice Address - Street 1:107 KINSLEY DR
Practice Address - Street 2:
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-7800
Practice Address - Country:US
Practice Address - Phone:570-402-0786
Practice Address - Fax:570-992-1668
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP112826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist