Provider Demographics
NPI:1003183765
Name:KNEDGEN, CHARLENE A (APRN)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:A
Last Name:KNEDGEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1865 PLUMAS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3386
Mailing Address - Country:US
Mailing Address - Phone:775-786-7440
Mailing Address - Fax:775-786-9389
Practice Address - Street 1:1865 PLUMAS ST STE 1
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3386
Practice Address - Country:US
Practice Address - Phone:775-786-7440
Practice Address - Fax:775-786-9389
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN000751363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner