Individual provider · Type 1 NPI

Genevieve Marie Konicke, PA-C

Surgical Physician Assistant · Austin, TX

NPI number 1710459896 Active

Practice location

4900 Mueller Blvd
Austin, TX 78723-3079

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA12417 (TX)

Surgical Physician Assistant: Definition to come...

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About NPI 1710459896

Genevieve Marie Konicke, PA-C's National Provider Identifier is 1710459896, issued on Dec 29, 2018. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Austin, TX. The record was last updated on Dec 29, 2018.