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NPI Code Detail

MEDICARE: CHRISTINA LEA KOENIG RN

MEDICARE:   CHRISTINA LEA KOENIG  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse0001241081VA

General Provider Information

NPI Number : 1770079865
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA LEA KOENIG RN
Provider Business Mailing Address
First Line : 2549 ELON DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-4353
Country : US
Telephone Number : 757-718-4917
Fax Number :
Provider Business Practice Location Address
First Line : 2549 ELON DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-4353
Country : US
Telephone Number : 757-718-4917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2018
Last Update Date : 07/02/2018

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