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Individual

DR. JENNIFER S. KNAPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
3220 E JEFFERSON BLVD, SOUTH BEND, IN 46615-3028
(574) 222-2466
(574) 222-2468
Mailing address
3220 E JEFFERSON BLVD, SOUTH BEND, IN 46615-3028
(574) 222-2466
(574) 222-2468

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
02003907A
IN
2084P0800X
Psychiatry Physician
34.009659
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000727514
ANTHEM
IN
01
02003907A
OSTEOPATH PHYSICIAN LICENSE
IN
05
201032160
IN
Enumeration date
05/10/2007
Last updated
02/09/2018
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