Healthcare Provider Details

I. General information

NPI: 1831527191
Provider Name (Legal Business Name): AUTUMN KARI KONZ PA-C, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AUTUMN K FINGERSON P.A.-C, MPH

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 MORREENE RD
DURHAM NC
27705-4410
US

IV. Provider business mailing address

4220 N ROXBORO ST
DURHAM NC
27704-1826
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-2875
  • Fax: 919-668-2901
Mailing address:
  • Phone: 865-599-1858
  • Fax: 919-668-5088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-6493
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA23245
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: