Provider Demographics
NPI:1215606793
Name:KNEPP, MORGAN MICHELE (PA-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MICHELE
Last Name:KNEPP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:MICHELE
Other - Last Name:GOODLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:137 FOREST HILL RD
Practice Address - Street 2:
Practice Address - City:MIFFLINBURG
Practice Address - State:PA
Practice Address - Zip Code:17844-7066
Practice Address - Country:US
Practice Address - Phone:570-966-1004
Practice Address - Fax:570-966-3736
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA005834363A00000X
PAMA062916363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty