Provider Demographics
NPI:1952028276
Name:KNUTSON, KALEH JUNE (FNP)
Entity Type:Individual
Prefix:
First Name:KALEH
Middle Name:JUNE
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KALEH
Other - Middle Name:JUNE
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1635 CAREGIVER CIR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-8529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 CAREGIVER CIR
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8529
Practice Address - Country:US
Practice Address - Phone:605-755-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002553363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily