Individual
JODI GAYLE KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP-AC
Contact information
Practice address
121 DENNIS DR, SEGUIN, TX 78155-0402
(308) 372-8981
(830) 372-8984
Mailing address
9223 HUBER RD, SEGUIN, TX 78155-1973
(830) 379-2663
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP120917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339554303
—
TX
Enumeration date
09/14/2011
Last updated
06/26/2024
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