Individual
THERESA KONIECZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
1919 LATHROP ST, FAIRBANKS, AK 99701-5937
(907) 459-3570
(907) 459-3510
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(352) 255-5586
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
237063
AK
363LF0000X
Family Nurse Practitioner
APRN11005954
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1755919
—
AK
01
—
F12190476
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
—
Enumeration date
03/26/2020
Last updated
08/09/2025
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