Provider Demographics
NPI:1275361503
Name:KNAPKE, SUSAN ANN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:KNAPKE
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:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:NORTH STAR
Mailing Address - State:OH
Mailing Address - Zip Code:45350-0085
Mailing Address - Country:US
Mailing Address - Phone:937-423-1894
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 85
Practice Address - Street 2:
Practice Address - City:NORTH STAR
Practice Address - State:OH
Practice Address - Zip Code:45350-0085
Practice Address - Country:US
Practice Address - Phone:937-423-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide