Individual
JENNEH KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6516 ZEALAND AVE N, BROOKLYN PARK, MN 55428-1930
(612) 201-7623
Mailing address
5775 WAYZATA BLVD, SUITE 700, ST LOUIS PARK, MN 55416-1222
(612) 799-6508
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L633370
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348032
CLASS A PROFESSIONAL HOME HEALTH CARE AGENCY
MN
Enumeration date
09/01/2010
Last updated
09/01/2010
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