Provider Demographics
NPI:1376783159
Name:KNEPPER, MICHELE M (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:KNEPPER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:M
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2140 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5122
Mailing Address - Country:US
Mailing Address - Phone:717-766-1795
Mailing Address - Fax:717-697-6575
Practice Address - Street 1:2140 FISHER RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5122
Practice Address - Country:US
Practice Address - Phone:717-766-1795
Practice Address - Fax:717-697-6575
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner