Individual
STEPHANIE JOY KNOBLOCH
Active
Individual
STEPHANIE JOY KNOBLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1437614
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163418600
—
MN
01
—
291G2KN
BLUE CROSS #
MN
01
—
P00297701
RAILROAD MEDICARE #
MN
Enumeration date
09/25/2006
Last updated
10/04/2022
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