Shirley Knackstedt, CFNP is a medicare enrolled "Nurse Practitioner - Family" in Los Ranchos, New Mexico. Her current practice location is
7218 4th St Nw, Los Ranchos, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 730-5603.
Shirley Knackstedt is licensed to practice in New Mexico (license number R39671/CNP00873) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114908761.
Provider's Profile
Full Name | Shirley Knackstedt |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 7218 4th St Nw, Los Ranchos, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1114908761
- Provider Enumeration Date: 11/10/2005
- Last Update Date: 04/04/2016
Medicare PECOS Information:
- PECOS PAC ID: 4486847829
- Enrollment ID: I20101019000242
Medical Identifiers
Medical identifiers for Shirley Knackstedt such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1114908761 | NPI | - | NPPES |
K3771 | Medicaid | NM | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | R39671/CNP00873 (New Mexico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shirley Knackstedt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shirley Knackstedt, CFNP 7218 4th St Nw, Los Ranchos, NM 87107-6624 Ph: (505) 730-5603 | Shirley Knackstedt, CFNP 7218 4th St Nw, Los Ranchos, NM 87107-6624 Ph: (505) 730-5603 |
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