Ellise Suzanne Koenn, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Fort Wayne, Indiana. Her current practice location is
10228 Dupont Circle Dr E Ste 100, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at
(260) 222-7401.
Ellise Suzanne Koenn is licensed to practice in Indiana (license number 71012516A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1952897092.
Physician's Profile
| Full Name | Ellise Suzanne Koenn |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 10228 Dupont Circle Dr E Ste 100, Fort Wayne, Indiana |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ellise Suzanne Koenn attended and graduated from in
NPI Data:
- NPI Number: 1952897092
- Provider Enumeration Date: 07/02/2018
- Last Update Date: 02/01/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Ellise Suzanne Koenn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1952897092 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | APRN.CNP.023023 (Ohio) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 71012516A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ellise Suzanne Koenn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ellise Suzanne Koenn, NP
Po Box 772437,
Detroit, MI 48277-2437
Ph: (317) 575-7304 | Ellise Suzanne Koenn, NP
10228 Dupont Circle Dr E Ste 100,
Fort Wayne, IN 46825-1611
Ph: (260) 222-7401 |
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