Provider Demographics
NPI:1770188823
Name:KNUTSEN, CATHARINA
Entity Type:Individual
Prefix:
First Name:CATHARINA
Middle Name:
Last Name:KNUTSEN
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 1:8005 S VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8940
Mailing Address - Country:US
Mailing Address - Phone:775-853-7555
Mailing Address - Fax:775-853-7583
Practice Address - Street 1:8005 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8940
Practice Address - Country:US
Practice Address - Phone:775-853-7555
Practice Address - Fax:775-853-7583
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist