Individual
ELISE FASSLER KONIGSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
1665 S LACHOLLA, TUCSON, AZ 85713
(520) 628-3068
(520) 628-4315
Mailing address
2255 N WYATT DR, TUCSON, AZ 85712
(520) 624-1761
(520) 622-8743
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN047199
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
643925
—
AZ
Enumeration date
07/01/2006
Last updated
07/08/2007
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