Provider Demographics
NPI:1114776754
Name:KNURR, JASMINE BARBARA (NP)
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:BARBARA
Last Name:KNURR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JASMINE
Other - Middle Name:BARBARA
Other - Last Name:KNURR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1320 E HIGH ST
Mailing Address - Street 2:3
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505
Mailing Address - Country:US
Mailing Address - Phone:937-917-9638
Mailing Address - Fax:
Practice Address - Street 1:306 BELLEAIRE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-4831
Practice Address - Country:US
Practice Address - Phone:937-315-0772
Practice Address - Fax:937-315-0999
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH98417822363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty