Koenig, Debra R

Koenig, Debra R is an individual health care provider with primary practice located at 1 Medical Village Dr , Edgewood KY 41017-3403. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Koenig, Debra R can be contacted via phone (859) 341-7246.

Contact Information

Primary practice address
1 Medical Village Dr Edgewood KY 41017-3403
Phone: (859) 341-7246
Fax: (859) 341-7867
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1053847 Kentucky

Profile Details

NPI number 1356326714
LBN Legal business name Koenig, Debra R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Dec 16th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356326714 NPPES
Other 000000288570 ANTHEM BLUE SHIELD
MEDICAID 74408725 ANTHEM BLUE SHIELD
MEDICAID 0875183 ANTHEM BLUE SHIELD
MEDICAID 200418550 ANTHEM BLUE SHIELD

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