Individual
SHANNON KONIECZKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CPNP
Contact information
Practice address
3901 BEAUBIEN ST., CHILDREN'S HOSPITAL OF MI, DETROIT, MI 48201-2119
(313) 993-2950
(313) 745-5237
Mailing address
4201 ST. ANTIONE UHC 5D, UNIVERDITY PEDIATRICIANS, DETROIT, MI 48201-2119
(313) 966-5051
(313) 966-0665
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704261113
MI
Other
Enumeration date
11/28/2011
Last updated
03/27/2013
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