Provider Demographics
NPI:1174378392
Name:KONZ, ALLYSON L (NP)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:L
Last Name:KONZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:
Other - Last Name:KEEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3851 NAVARRE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3671
Mailing Address - Country:US
Mailing Address - Phone:419-696-8255
Mailing Address - Fax:
Practice Address - Street 1:3851 NAVARRE AVE STE 200
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3671
Practice Address - Country:US
Practice Address - Phone:419-344-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH432365163W00000X
OHAPRN.CNP.0036729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse