Provider Demographics
NPI:1518013101
Name:KNAPE, JESSICA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:KNAPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1222 SCRUB OAK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:303-909-1215
Mailing Address - Fax:
Practice Address - Street 1:10900 W 44TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2742
Practice Address - Country:US
Practice Address - Phone:303-993-1330
Practice Address - Fax:303-957-5757
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11906740Medicaid
COCOA100054Medicare PIN