Provider Demographics
NPI:1790928778
Name:KNIPS, JENNIFER LYNNE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:KNIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 KINGSBOROUGH SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4999
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:908 EDEN WAY N STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3336
Practice Address - Country:US
Practice Address - Phone:757-312-6267
Practice Address - Fax:757-819-7185
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVIRGINIA HEALTH NETWORK
VA10094802OtherOPTIMA HEALTH
VA1790928778OtherCOVENTRY HEALTH NETWORK
VAPAROtherCORVEL
VA-028OtherCHAMPUS/TRICARE
VA1790928778OtherVIRGINIA PREMIER HEALTH PLAN
VA1790928778OtherUNITED HEALTHCARE
VA458844OtherANTHEM BC/BS
NC5919942Medicaid
VAPAROtherCIGNA
VAPAROtherAETNA
VA1790928778Medicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherMULTIPLAN
VAPAROtherCORVEL
NC5919942Medicaid