Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN000751 | NV |
NPI | 1003183765 |
---|---|
Provider Name | Charlene Ann Knedgen |
First Address | Reno, NV 89509-3683 |
Second Address | Reno, NV 89509-3683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2011 |
Last Update Date | 05/04/2018 |