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Individual
PETER SHENK KOONTZ
Active
Individual
PETER SHENK KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
79927
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71010058A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
79927
NM
Other
Enumeration date
08/15/2017
Last updated
05/07/2025
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