Provider Demographics
NPI:1659346864
Name:KNAUF, SANDRA (MSN RN CS)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:KNAUF
Suffix:
Gender:F
Credentials:MSN RN CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5472 GOVERNORS AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1400
Mailing Address - Country:US
Mailing Address - Phone:248-787-2338
Mailing Address - Fax:
Practice Address - Street 1:13777 PEARL RD
Practice Address - Street 2:MINUTE CLINIC
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-4900
Practice Address - Country:US
Practice Address - Phone:440-238-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12295-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P34780024Medicare UPIN