Kelly Dawn Knauss
Individual provider Active NPI Attendant Care Provider · Bluford, IL
NPI 1033760418 · NPPES record last updated May 1, 2020
Key facts
- NPI
- 1033760418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 612 W 5TH St
Bluford, IL 62814-1400 - Phone
- (618) 214-1058
- NPI assigned
- Sep 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
612 W 5TH St
Bluford, IL 62814-1400
Mailing address
612 W 5TH St
Bluford, IL 62814-1400
Phone (618) 214-1058
Other providers in Bluford, IL
- Bluford Grade School
- Bluford Unit School District #318
- Brenna Collins
- County of Jefferson Webber Township High SCH Dist 204
- Farrington Community Consolidated School
- Ronald L. Weinstein
All providers in Bluford, IL · Attendant Care Provider in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.