1326210782 NPI number — MRS. RHONDA ANN KNECHT R.D., C.D.

Table of content: MRS. RHONDA ANN KNECHT R.D., C.D. (NPI 1326210782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326210782 NPI number — MRS. RHONDA ANN KNECHT R.D., C.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNECHT
Provider First Name:
RHONDA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.D., C.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PERRY
Provider Other First Name:
RHONDA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.D., C.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326210782
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
316 WOODSIDE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THIENSVILLE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53092-1341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-242-1379
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
W180N8085 TOWN HALL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MENOMONEE FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53051-3518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-257-3130
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2008

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: 133V00000X , with the licence number:  725108 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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