Individual
MICHELLE TRACY KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
2220 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1321
(612) 341-5100
Mailing address
2220 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1321
(612) 341-5100
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP0364
MN
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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