Provider Demographics
NPI:1538405139
Name:KNAPP, KAITLIN MICHELLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:MICHELLE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:KAITLIN
Other - Middle Name:MICHELLE
Other - Last Name:WALDRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:431 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04276-2100
Mailing Address - Country:US
Mailing Address - Phone:207-364-7831
Mailing Address - Fax:207-369-9467
Practice Address - Street 1:431 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276-2100
Practice Address - Country:US
Practice Address - Phone:207-364-7831
Practice Address - Fax:207-369-9467
Is Sole Proprietor?:No
Enumeration Date:2012-12-31
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP121120363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily