Individual
MRS. PAMELA J. KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP
Contact information
Practice address
30 BOYNTON ST, EASTPORT, ME 04631-1306
(207) 853-6001
(207) 853-6180
Mailing address
30 BOYNTON ST, EASTPORT, ME 04631-1306
(207) 853-6001
(207) 853-6180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
CNP111017
ME
363LF0000X
Family Nurse Practitioner
Primary
SP008472
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013058240001
—
PA
Enumeration date
06/16/2005
Last updated
12/09/2011
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