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Individual

NICOLE THERESA KONSCHNIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4255 ALTAMONT PL STE 301, WHITE PLAINS, MD 20695-3082
(301) 645-1781
(301) 374-9237
Mailing address
4255 ALTAMONT PL STE 301, WHITE PLAINS, MD 20695-3082
(301) 645-1781

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0009171
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009094448001
UNITED HEALTHCARE
MD
01
20836234
WELLPOINT
MD
01
912075100
MEDICAL ASSISTANCE
MD
Enumeration date
08/08/2022
Last updated
02/03/2026
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