Provider Demographics
NPI:1336478007
Name:KOENIG, SARA M (WHNP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:M
Last Name:KOENIG
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD STE 4017B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8269
Mailing Address - Country:US
Mailing Address - Phone:314-872-9192
Mailing Address - Fax:314-872-4234
Practice Address - Street 1:621 S NEW BALLAS RD STE 4017B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8269
Practice Address - Country:US
Practice Address - Phone:314-872-9192
Practice Address - Fax:314-872-4234
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009034348363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health