Provider Demographics
NPI:1558759688
Name:KNAPP, KRISTEN J (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:J
Last Name:KNAPP
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:J
Other - Last Name:NEVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4676 DEPARTMENT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-4676
Mailing Address - Country:US
Mailing Address - Phone:952-442-9770
Mailing Address - Fax:952-442-3620
Practice Address - Street 1:1 WILLIAM CARLS DR
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-2201
Practice Address - Country:US
Practice Address - Phone:248-937-3390
Practice Address - Fax:952-442-3620
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272062367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered