Individual
HEIDI KNIPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
Mailing address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05435
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KBC4HO-64320701
BC/BS
MD
01
—
S4040015
CAREFIRST
MD
Enumeration date
07/24/2006
Last updated
07/21/2022
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