Individual
MR. LE ROY M KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ANP-C, GNP
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-0001
(520) 792-1450
(520) 629-4783
Mailing address
8843 E BUCKBOARD RD, TUCSON, AZ 85749-9658
(520) 792-1450
(520) 629-4783
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN035147
AZ
363LA2100X
Acute Care Nurse Practitioner
AP7102
AZ
363LA2200X
Adult Health Nurse Practitioner
267
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP7102
AZ
363LG0600X
Gerontology Nurse Practitioner
13
AZ
Other
Enumeration date
07/19/2006
Last updated
12/06/2019
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