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Individual

DEBRA ANN KOENKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2123 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 585-2791
(513) 421-2601
Mailing address
237 WILLIAM HOWARD TAFT RD, 2ND FLOOR, CBO2-3, ATTN: CREDENTIALING, CINCINNATI, OH 45219-2610
(513) 263-8551
(513) 366-4480

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
COA.15350
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
COA.15350
OH

Other

Enumeration date
12/30/2013
Last updated
12/30/2013
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