Provider Demographics
NPI:1508850561
Name:KNAPP, LINDA J (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:KNAPP
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3555 WILLOW LK BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55110
Mailing Address - Country:US
Mailing Address - Phone:651-770-2124
Mailing Address - Fax:651-770-3701
Practice Address - Street 1:3555 WILLOW LK BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110
Practice Address - Country:US
Practice Address - Phone:651-770-2124
Practice Address - Fax:651-770-3701
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2016-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN360272080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1226436OtherMEDICA
MN012078200Medicaid
MN1226435OtherMEDICA
MNCP9090577009OtherPREFERRED ONE
MN299L5KNOtherBLUE CROSS BLUE SHIELD
A99129Medicare UPIN