Individual
KAIA MARIE KNUTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 858-2186
(970) 858-2208
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01074439A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201097900
—
IN
Enumeration date
05/14/2012
Last updated
06/26/2024
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