Provider Demographics
NPI:1417608852
Name:IKNOW CPR AND MORE LLC
Entity Type:Organization
Organization Name:IKNOW CPR AND MORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:OUTLAW
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:757-748-4643
Mailing Address - Street 1:3140 CANNON DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5533
Mailing Address - Country:US
Mailing Address - Phone:757-748-4643
Mailing Address - Fax:
Practice Address - Street 1:3140 CANNON DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5533
Practice Address - Country:US
Practice Address - Phone:469-686-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff DevelopmentGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical Laboratory
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Single Specialty