Provider Demographics
NPI:1083854368
Name:KNAPP, EMILY KATHLEEN (LPN)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHLEEN
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 KATHAN RD
Mailing Address - Street 2:
Mailing Address - City:BREWERTON
Mailing Address - State:NY
Mailing Address - Zip Code:13029-9531
Mailing Address - Country:US
Mailing Address - Phone:315-668-1406
Mailing Address - Fax:
Practice Address - Street 1:5519 KATHAN RD
Practice Address - Street 2:
Practice Address - City:BREWERTON
Practice Address - State:NY
Practice Address - Zip Code:13029-9531
Practice Address - Country:US
Practice Address - Phone:315-668-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236372-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02865589Medicaid