Provider Demographics
NPI:1386925105
Name:KNAPP, LISA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14306 BROOKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2044
Mailing Address - Country:US
Mailing Address - Phone:515-987-0270
Mailing Address - Fax:
Practice Address - Street 1:104 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-4507
Practice Address - Country:US
Practice Address - Phone:515-243-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist