Provider Demographics
NPI:1790928778
Name:KNIPS, JENNIFER LYNNE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:KNIPS
Suffix:
Gender:F
Credentials:MD
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 936
Mailing Address - Street 2:EVMS HEALTH SERVICES
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-8920
Mailing Address - Fax:757-446-5242
Practice Address - Street 1:825 FAIRFAX AVE STE 445
Practice Address - Street 2:EVMS INTERNAL MEDICINE
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-8920
Practice Address - Fax:757-446-5242
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919942Medicaid
VAPAROtherCIGNA
VA1790928778OtherCOVENTRY HEALTH NETWORK
VAPAROtherAETNA
VA1790928778OtherVIRGINIA PREMIER HEALTH PLAN
VA-028OtherCHAMPUS/TRICARE
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL
VA1790928778OtherUNITED HEALTHCARE
VAPAROtherMULTIPLAN
VA10094802OtherOPTIMA HEALTH
VA1790928778Medicaid
VA458844OtherANTHEM BC/BS
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCORVEL
NC5919942Medicaid