Provider Demographics
NPI:1508562810
Name:KNAPP, ANN G
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:G
Last Name:KNAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 E 130TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MULVANE
Mailing Address - State:KS
Mailing Address - Zip Code:67110-8332
Mailing Address - Country:US
Mailing Address - Phone:316-200-4454
Mailing Address - Fax:
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2332424042164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse