Provider Demographics
NPI:1689453623
Name:KOENIG, ELLEE ELAINE
Entity Type:Individual
Prefix:
First Name:ELLEE
Middle Name:ELAINE
Last Name:KOENIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 DONA DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-8342
Mailing Address - Country:US
Mailing Address - Phone:740-319-4710
Mailing Address - Fax:
Practice Address - Street 1:3775 DONA DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-8342
Practice Address - Country:US
Practice Address - Phone:740-319-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant