Individual
STEPHANIE M KNAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2323 N CASALOMA DR, APPLETON, WI 54913-8284
(920) 730-8833
(920) 730-8263
Mailing address
2323 N CASALOMA DR, APPLETON, WI 54913-8284
(920) 730-8833
(920) 730-8263
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2997
WI
363AS0400X
Surgical Physician Assistant
2997
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45232
MEDICARE PTAN
WI
Enumeration date
08/15/2012
Last updated
08/15/2012
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