Provider Demographics
NPI:1003062944
Name:KNAPP, JESSICA A (LPN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8573 WEEDSPORT SENNETT RD
Mailing Address - Street 2:
Mailing Address - City:WEEDSPORT
Mailing Address - State:NY
Mailing Address - Zip Code:13166-9778
Mailing Address - Country:US
Mailing Address - Phone:315-412-7578
Mailing Address - Fax:
Practice Address - Street 1:8573 WEEDSPORT SENNETT RD
Practice Address - Street 2:
Practice Address - City:WEEDSPORT
Practice Address - State:NY
Practice Address - Zip Code:13166-9778
Practice Address - Country:US
Practice Address - Phone:315-412-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283698-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse