Provider Demographics
NPI:1407906373
Name:KNOPP, ANDREA FORTSON (FNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:FORTSON
Last Name:KNOPP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 MIDDLEBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-4545
Mailing Address - Country:US
Mailing Address - Phone:540-294-3238
Mailing Address - Fax:
Practice Address - Street 1:934 N AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3215
Practice Address - Country:US
Practice Address - Phone:540-885-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167074363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner