Provider Demographics
NPI:1477879484
Name:KNOP DUMSTORFF, JOCELYN L (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:L
Last Name:KNOP DUMSTORFF
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:L
Other - Last Name:KNOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 WAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-9776
Mailing Address - Country:US
Mailing Address - Phone:515-480-3359
Mailing Address - Fax:
Practice Address - Street 1:100 WAUKEE AVE
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-9776
Practice Address - Country:US
Practice Address - Phone:515-480-3359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE901729367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered