Individual
RAELENE MICHELLE KNOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3901 RAINBOW BLVD, MS 1046, KANSAS CITY, KS 66160-0001
(913) 588-6777
(913) 588-6765
Mailing address
3901 RAINBOW BLVD, MS 1046, KANSAS CITY, KS 66160-0001
(913) 588-6777
(913) 588-6765
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
6363
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006012780
MISSOURI TEMP LICENSE
ME
01
—
6363
KANSAS TEMPORARY LICENSE
KS
Enumeration date
03/08/2007
Last updated
03/07/2023
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