Provider Demographics
NPI:1063178796
Name:KNUEPPEL, HANNAH M
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:M
Last Name:KNUEPPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-5947
Mailing Address - Country:US
Mailing Address - Phone:732-575-9607
Mailing Address - Fax:
Practice Address - Street 1:313 W WATER ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6693
Practice Address - Country:US
Practice Address - Phone:732-333-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty