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General NPI Number Information
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NPI Number | 1518208339
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Entity Type | Individual
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Provider Name | DANA JOANN KOENNING NP
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Gender | Female
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 308 E EDGEWOOD DR
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-3823
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Country | US
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Telephone | 281-684-6286
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Fax |
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Provider Business Mailing Address
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Address Line | 2306 BUTLER DR
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5518
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Country | US
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Telephone | 281-684-6286
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Fax | 281-286-7557
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 705499
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License Number State | TX
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