Provider Demographics
NPI:1780849869
Name:KNEIP, RENEE (OT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:KNEIP
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5045
Mailing Address - Street 2:ATTN: PROV ENROLLMENT
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5045
Mailing Address - Country:US
Mailing Address - Phone:605-322-6428
Mailing Address - Fax:
Practice Address - Street 1:4500 S PRINCE OF PEACE PL
Practice Address - Street 2:SUITE 1
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-5830
Practice Address - Country:US
Practice Address - Phone:605-322-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0133225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1780849869OtherBCBSMN
SD1780849869OtherWELLMARK BCBS; TRICARE
MN1780849869Medicaid
NE10025846700Medicaid
IA1780849869Medicaid
SD9290501OtherDAKOTACARE
SD1780849869OtherWELLMARK BCBS; TRICARE