Provider Demographics
NPI:1013082684
Name:KNAPP-PHILLIPS, CHRISTINE JENNIFER (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JENNIFER
Last Name:KNAPP-PHILLIPS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SIENA
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8631
Mailing Address - Country:US
Mailing Address - Phone:949-363-1329
Mailing Address - Fax:
Practice Address - Street 1:757 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3944
Practice Address - Country:US
Practice Address - Phone:909-607-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA514129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily