Provider Demographics
NPI:1962436162
Name:KNIPRATH, DENISE R (NP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:R
Last Name:KNIPRATH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-4714
Mailing Address - Country:US
Mailing Address - Phone:715-422-7750
Mailing Address - Fax:715-422-7752
Practice Address - Street 1:420 DEWEY ST
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-4714
Practice Address - Country:US
Practice Address - Phone:715-422-7750
Practice Address - Fax:715-422-7752
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1346-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43981400Medicaid
WI43981400Medicaid
P77507Medicare UPIN