Provider Demographics
NPI:1124234927
Name:KNAPP, CONNIE L (APN)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:L
Last Name:KNAPP
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 N GREEN VALLEY PKWY
Mailing Address - Street 2:#345
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074
Mailing Address - Country:US
Mailing Address - Phone:702-260-0600
Mailing Address - Fax:702-260-4444
Practice Address - Street 1:100 N GREEN VALLEY PKWY
Practice Address - Street 2:#345
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-260-0600
Practice Address - Fax:702-260-4444
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00159363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2042097Medicaid