Provider Demographics
NPI:1205372976
Name:KOENIGSEDER, SHERRIE MELISSA (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:MELISSA
Last Name:KOENIGSEDER
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:7565 FRANKFORT ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7713
Mailing Address - Country:US
Mailing Address - Phone:850-313-1323
Mailing Address - Fax:850-684-3066
Practice Address - Street 1:1772 SEA LARK LN
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7472
Practice Address - Country:US
Practice Address - Phone:850-939-9721
Practice Address - Fax:850-684-3066
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2023-12-15
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Provider Licenses
StateLicense IDTaxonomies
FL9322569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111835800Medicaid