Provider Demographics
NPI:1376231118
Name:KNIPP, STEPHANIE RENEE
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:RENEE
Last Name:KNIPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45634-8748
Mailing Address - Country:US
Mailing Address - Phone:740-710-1642
Mailing Address - Fax:
Practice Address - Street 1:133 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45634-8748
Practice Address - Country:US
Practice Address - Phone:740-710-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide