Provider Demographics
NPI:1619446705
Name:KNAPP, LAURA LEA (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:KNAPP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 HOLLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2529
Mailing Address - Country:US
Mailing Address - Phone:850-517-7245
Mailing Address - Fax:
Practice Address - Street 1:19 LAKES ST.
Practice Address - Street 2:
Practice Address - City:NESPELEM
Practice Address - State:WA
Practice Address - Zip Code:99155
Practice Address - Country:US
Practice Address - Phone:509-634-2900
Practice Address - Fax:509-634-2945
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9171507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse