Individual
DEJA SHARI KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4400 BROWNSVILLE RD STE 105, POWDER SPRINGS, GA 30127-8902
(516) 830-5338
(470) 523-2573
Mailing address
4034 OAK HILL RD, DOUGLASVILLE, GA 30135-5026
(516) 830-5338
(470) 523-2573
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN-NP282683
GA
363LF0000X
Family Nurse Practitioner
95013548
CA
Other
Enumeration date
01/14/2020
Last updated
10/29/2025
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