Provider Demographics
NPI:1649652306
Name:KNAUSS, KAYLA S (DO)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:S
Last Name:KNAUSS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-0469
Mailing Address - Country:US
Mailing Address - Phone:308-537-3661
Mailing Address - Fax:308-537-3074
Practice Address - Street 1:918 20TH ST
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138
Practice Address - Country:US
Practice Address - Phone:308-537-4066
Practice Address - Fax:308-537-4038
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine