Provider Demographics
NPI:1558605808
Name:KNAPP, ROBERTA JEAN
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:JEAN
Last Name:KNAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ROBERTA
Other - Middle Name:JEAN
Other - Last Name:KNAPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2543 SE VAN SKIVER RD
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-8518
Mailing Address - Country:US
Mailing Address - Phone:907-841-5048
Mailing Address - Fax:
Practice Address - Street 1:450 S KITSAP BLVD STE 260
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3739
Practice Address - Country:US
Practice Address - Phone:253-888-1935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60157340163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health