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Ellise Suzanne Koenn, NP
Family Nurse Practitioner in Fort Wayne, Indiana
NPI 1952897092

Ellise Suzanne Koenn is a Family Nurse Practitioner based in Detroit, IN and is specialized in Family. Ellise Suzanne Koenn practices in Fort Wayne, IN and has the professional credentials of NP. The NPI Number for Ellise Suzanne Koenn is 1952897092 and holds a License No. APRN.CNP.023023 (Indiana).

The current practice location address for Ellise Suzanne Koenn is 10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN and can be reached out via phone at 260-222-7401 and via fax at 260-209-5956.

Location: 10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN, 48277-2437
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952897092
Provider Name
Ellise Suzanne Koenn
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN, 48277-2437
Phone Number
260-222-7401
Fax Number
260-209-5956
Provider Enumeration Date
07/02/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
10228 Dupont Circle Dr E Ste 100
City
Fort Wayne
State
Indiana
Zip
46825-1611
Phone Number
260-222-7401
Fax Number
260-209-5956
person
Provider Business Mailing Address Details
Address
10228 Dupont Circle Dr E Ste 100
City
Fort Wayne
State
Indiana
Zip
46825-1611
Phone Number
260-222-7401
Fax Number
260-209-5956
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
71012516A (Indiana)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
APRN.CNP.023023 (Ohio)
Definition
Definition to come...
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