Provider Demographics
NPI:1689226847
Name:KNAPP, SHAUNA MARIE
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:MARIE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 MERIDIAN ST STE 215
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-1761
Mailing Address - Country:US
Mailing Address - Phone:317-453-0071
Mailing Address - Fax:
Practice Address - Street 1:1106 MERIDIAN ST STE 215
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1761
Practice Address - Country:US
Practice Address - Phone:317-453-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor