Individual
MRS. CHRISTIE LEIGH KOEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
24 CARROW ST, ORCHARD PARK, NY 14127-2604
(716) 662-3443
(716) 972-0374
Mailing address
24 CARROW ST, ORCHARD PARK, NY 14127-2604
(716) 662-3443
(716) 972-0374
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381603
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026923001
UNIVERA HEALTHCARE
NY
01
—
000560738003
BLUE CROSS/BLUE SHIELD (HEALTH NOW)
NY
05
—
02529793
—
NY
01
—
9512152
INDEPENDENT HEALTH ASSOCIATION
NY
Enumeration date
09/22/2006
Last updated
06/26/2008
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