Provider Demographics
NPI:1801652474
Name:KONEY, KRISTIE MARIE (APNP)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:MARIE
Last Name:KONEY
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E PINE HOLLOW LN APT 3
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-7720
Mailing Address - Country:US
Mailing Address - Phone:262-825-6905
Mailing Address - Fax:
Practice Address - Street 1:3501 E RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3009
Practice Address - Country:US
Practice Address - Phone:414-769-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15071-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily