MICHELLE TRACY KOENIG (NPI# 1023402658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023402658 |
| Entity Type | Individual |
| Full Name | MICHELLE TRACY KOENIG |
| Credential | DNP |
| Practice Address |
2220 Riverside Ave Minneapolis MN 55454-1321 |
| Practice Telephone | 6123415100 |
| Mailing Telephone | 6123415100 |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
CNP0364 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881105617 | Michelle Koenig | Behavior Technician | 6714 Winkler Rd, Fort Myers, FL 33919-7204 | 2017-10-19 |
| 1407120587 | Michelle Koenig | Massage Therapist | 207 1st Ave S, Suite B, New Rockford, ND 58356-1800 | 2012-03-06 |
| Street Address |
2220 RIVERSIDE AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55454-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619972197 | Sean Thayer | Podiatrist | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2005-06-20 |
| 1578187084 | Marcia Wahl | Registered Nurse | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2020-05-31 |
| 1619499746 | Kathleen Ann Otremba | Nurse Practitioner | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2017-07-11 |
| 1417490228 | Lucianna Baregi | Physical Therapist | 2220 Riverside Ave, 5th Floor, Minneapolis, MN 55454-1321 | 2016-11-28 |
| 1609256031 | Lydia Staples | Obstetrics & Gynecology | 2220 Riverside Ave, Mail Stop 31700a, Minneapolis, MN 55454 | 2015-06-01 |
| 1821476821 | Melissa Pavek | Family Medicine | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2015-05-11 |
| 1699166082 | Linnea Marie Forsline | Physician Assistant | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2015-02-06 |
| 1699199802 | Zachery Avir Lecrone | Social Worker | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2014-02-07 |
| 1386083111 | Laura Virginia Maus | Internal Medicine | 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2013-06-14 |
| 1548607666 | Daniel Joseph Denucci | Dentist | 2220 Riverside Ave, Minneapolis, MN 55454 | 2013-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341842 | Bruce Zhang | Student in an Organized Health Care Education/Training Program | 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 | 2020-06-18 |
| 1205456738 | Sara Segner | Student in an Organized Health Care Education/Training Program | Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-24 |
| 1417576844 | Sabena Khan | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 | 2020-04-15 |
| 1811525983 | Kayla Joy Solstad | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-01 |
| 1720647126 | Lauren Harasymiw | Student in an Organized Health Care Education/Training Program | Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-06-10 |
| 1689237448 | Katelyn Marie Adams | Student in an Organized Health Care Education/Training Program | Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-17 |
| 1285197848 | Adrienne Bruder | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-10 |
| 1588142855 | Stewart Graeme Morrison | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 | 2018-07-30 |
| 1831682251 | Sherab Tsheringla | Student in an Organized Health Care Education/Training Program | 2450 Riverside Avenue South, Minneapolis, MN 55454 | 2018-06-11 |
| 1669962148 | Pooja Elizabeth Mishra | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 | 2018-05-10 |
| Find all providers in zip 55454 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720407497 | Halley Gail Sage | Nurse Practitioner | 2525 Chicago Ave S., Minneapolis, MN 55404 | 2014-04-10 |
| 1457509523 | Rebecca Olson | Nurse Practitioner | 2525 Chicago Avenue, Minneapolis, MN 55404-4518 | 2008-09-03 |
| 1912108341 | Nancy Novakoske Hoogenhous | Nurse Practitioner | 200 Oak St Se, Ste 160, Minneapolis, MN 55455-2009 | 2007-05-31 |
| 1902988421 | Alexis Maciej | Nurse Practitioner | 424 Haravard St Se, Suite M100 Masonic Cancet Center, University of Minnesota Physicians, Minneapolis, MN 55455 | 2006-10-20 |
| 1669568176 | Jill Lunsford Lee | Nurse Practitioner | 420 Delaware St., Mmc 484, Minneapolis, MN 55455 | 2006-10-04 |
| 1477561991 | Mary Jordan | Nurse Practitioner | 2001 Bloomington Avenue S, Community-university Health Care Center, Minneapolis, MN 55404-3074 | 2006-08-03 |
| 1457327686 | Judith A Kralewski | Nurse Practitioner | 250 S 4th St, Room 510, Minneapolis, MN 55415-1335 | 2006-02-27 |
| 1689644908 | Tambra R Dahlheimer | Nurse Practitioner | 2450 Riverside Ave Se, East Building Journey Clinic 9e, Minneapolis, MN 55454 | 2006-01-26 |
| 1881207462 | Brianna Marie Gloe | Nurse Practitioner | 2530 Chicago Ave Ste 550, Minneapolis, MN 55404-4293 | 2020-08-25 |
| 1447861067 | Charlotte Minnema | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-08-17 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55454 |
Please comment or provide details below to improve the information on MICHELLE TRACY KOENIG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.