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Individual
GINA M KOONS
Active
Individual
GINA M KOONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN626441
PA
363L00000X
Nurse Practitioner
NPPA034189
PA
363L00000X
Nurse Practitioner
Primary
SP018978
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035443590002
—
PA
01
—
1H8232
MEDICARE
PA
Enumeration date
07/12/2018
Last updated
04/26/2022
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