Doctor Name: | MRS. PAMELA J. KOENIG |
NPI Number: | 1376548446 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, CRNP |
License Number: | CNP111017 |
Business Practice Address: | 30 Boynton St Eastport, ME - 046311306 |
Business Phone Number: | 2078536001 |
Business Fax Number: | 2078536180 |
Mailing Address: | 30 Boynton St, EASTPORT |
State: | ME |
Postal Code: | 046311306 |
Phone Number: | 2078536001 |
Fax Number: | 2078536180 |
NPI Enumeration Date: | 06/16/2005 |
NPI Last Update Date: | 12/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP111017 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |