Provider Demographics
NPI:1194315127
Name:KNIPP, JOHANNA LYNN
Entity type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:LYNN
Last Name:KNIPP
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 1:1814 CAIRNS RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-9095
Mailing Address - Country:US
Mailing Address - Phone:419-688-1651
Mailing Address - Fax:
Practice Address - Street 1:1814 CAIRNS RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-9095
Practice Address - Country:US
Practice Address - Phone:419-688-1651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker