Basic Information
| Provider Information | |||||||||
| NPI: | 1922512144 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KNEPP | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | MEGHAN | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2005 TECHNOLOGY PKWY STE 400 | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170509413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177912520 | ||||||||
| FaxNumber: | 7177030061 | ||||||||
| Practice Location | |||||||||
| Address1: | 2005 TECHNOLOGY PKWY STE 400 | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170509413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177912520 | ||||||||
| FaxNumber: | 7177030061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2017 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | SP018131 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LG0600X | SP018131 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363L00000X | SP018131 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 103456149 | 05 | PA | MEDICAID |