1811015449 NPI number — MRS. DEBORAH JEANNETTE KNISPEL REGISTERED NURSE

Table of content: MRS. DEBORAH JEANNETTE KNISPEL REGISTERED NURSE (NPI 1811015449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811015449 NPI number — MRS. DEBORAH JEANNETTE KNISPEL REGISTERED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNISPEL
Provider First Name:
DEBORAH
Provider Middle Name:
JEANNETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHWAB
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
JEANNETTE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICENSE PRACTICAL NU
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811015449
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25586 SOUTH DAKOTA HWY 44
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE RIVER
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-259-3446
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 SOLDIER CREEK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEBUD
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57570-0400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-747-3245
Provider Business Practice Location Address Fax Number:
605-747-5348
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  53860 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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