Provider Demographics
NPI:1467800649
Name:KONZEM, ANN GIELYN SILVA-ABUEG (PA-C)
Entity Type:Individual
Prefix:
First Name:ANN GIELYN
Middle Name:SILVA-ABUEG
Last Name:KONZEM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7976
Mailing Address - Country:US
Mailing Address - Phone:951-237-6506
Mailing Address - Fax:
Practice Address - Street 1:2906 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-1921
Practice Address - Country:US
Practice Address - Phone:252-823-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-29
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07588363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty