Knack, Kevin Michael

Knack, Kevin Michael is an individual health care provider with primary practice located at 655 Redwood Hwy Frontage Rd Ste 240 , Mill Valley CA 94941-3055. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Knack, Kevin Michael can be contacted via phone (866) 247-4292.

Contact Information

Primary practice address
655 Redwood Hwy Frontage Rd Ste 240 Mill Valley CA 94941-3055
Phone: (866) 247-4292
Fax: (866) 247-4292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 95014679 California
Nursing Service Providers / Registered Nurse 163W00000X RN60313579 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95014679 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP60313580 Washington

Profile Details

NPI number 1376852772
LBN Legal business name Knack, Kevin Michael
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2010
Last updated Feb 1st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376852772 NPPES
Washington MEDICAID 2025451

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