Individual
CARRIE SUE KNIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6654
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(814) 877-5510
(814) 877-5518
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2288
SC
363A00000X
Physician Assistant
OA002163
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02880931
NY MEDICAL ASSISTANCE
NY
01
—
1765844
BLUE SHIELD
PA
05
—
2477PA
—
SC
01
—
P00396195
RR MEDICARE
PA
Enumeration date
06/22/2005
Last updated
01/29/2021
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