Provider Demographics
NPI:1891300448
Name:KNAPP, ALISSA LYNNE (RN)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:LYNNE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:NE
Mailing Address - Zip Code:68873-1402
Mailing Address - Country:US
Mailing Address - Phone:308-754-4433
Mailing Address - Fax:308-754-5374
Practice Address - Street 1:1305 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:NE
Practice Address - Zip Code:68873-1402
Practice Address - Country:US
Practice Address - Phone:308-754-4433
Practice Address - Fax:308-754-5374
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse