Provider Demographics
NPI:1487659371
Name:KNOPF, KARRIE L (PA-C)
Entity Type:Individual
Prefix:
First Name:KARRIE
Middle Name:L
Last Name:KNOPF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARRIE
Other - Middle Name:
Other - Last Name:ROBISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:196 ARROWHEAD DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-8752
Mailing Address - Country:US
Mailing Address - Phone:307-783-8123
Mailing Address - Fax:615-465-2894
Practice Address - Street 1:196 ARROWHEAD DR
Practice Address - Street 2:STE 1
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-8752
Practice Address - Country:US
Practice Address - Phone:307-783-8123
Practice Address - Fax:307-783-8254
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY114390500Medicaid
WY114390500Medicaid
WYW308622Medicare PIN