Provider Demographics
NPI:1497631451
Name:KOENIGSMANN, POLINA (NP)
Entity type:Individual
Prefix:
First Name:POLINA
Middle Name:
Last Name:KOENIGSMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8459 SHELDON BRANCH PL
Mailing Address - Street 2:
Mailing Address - City:TOANO
Mailing Address - State:VA
Mailing Address - Zip Code:23168-9272
Mailing Address - Country:US
Mailing Address - Phone:757-272-4989
Mailing Address - Fax:
Practice Address - Street 1:8459 SHELDON BRANCH PL
Practice Address - Street 2:
Practice Address - City:TOANO
Practice Address - State:VA
Practice Address - Zip Code:23168-9272
Practice Address - Country:US
Practice Address - Phone:757-272-4989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24194266363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner