Individual
KELLY ANN KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3600
(937) 641-5802
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004960RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215468
—
OH
Enumeration date
01/17/2017
Last updated
02/13/2026
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