Provider Demographics
NPI:1720419310
Name:COUGHS-N-SNIFFLES CLINIC
Entity Type:Organization
Organization Name:COUGHS-N-SNIFFLES CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:207-739-2873
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-0534
Mailing Address - Country:US
Mailing Address - Phone:207-739-2873
Mailing Address - Fax:207-739-2874
Practice Address - Street 1:4 MARKET SQ
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH PARIS
Practice Address - State:ME
Practice Address - Zip Code:04281-1563
Practice Address - Country:US
Practice Address - Phone:207-739-2873
Practice Address - Fax:207-739-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1194849380Medicaid
001544101Medicare Oscar/Certification