Provider Demographics
NPI:1821769829
Name:KONKEL, CHRISTINE MONICA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MONICA
Last Name:KONKEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:MONICA
Other - Last Name:PUTZIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:350 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4496
Practice Address - Country:US
Practice Address - Phone:602-406-8302
Practice Address - Fax:602-406-7247
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ264402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily