Individual
TERA L KNEPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1401 MEMORIAL AVE STE B, WASHINGTON, IN 47501-3154
(812) 254-2400
(812) 254-3191
Mailing address
1401 MEMORIAL AVE STE B, WASHINGTON, IN 47501-3154
(812) 254-2400
(812) 254-3191
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002022A
IN
363LW0102X
Women's Health Nurse Practitioner
71002022A
IN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
71002022A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000390526
ANTHEM
IN
05
—
200800420
—
IN
01
—
DQ1052
GROUP RRMCR
IN
01
—
P1660790
RRMCR
IN
Enumeration date
03/08/2006
Last updated
08/01/2016
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