Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellise Suzanne Koenn, NP

Individual provider Family Medicine Physician · NPI 1952897092

Ellise Suzanne Koenn, NP is a Family Medicine Physician in Fort Wayne, Indiana. Works from 2 locations. Licensed in Indiana and Ohio.

Licensed in
IN, OH
In the registry since
2018
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

10228 Dupont Circle Dr E Ste 100
Fort Wayne, IN 46825-1611
Phone: (260) 222-7401
Fax: (260) 209-5956
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 107 Buffalo Street, Antwerp, OH 45813 — (419) 258-5641

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71012516A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence APRN.CNP.023023 (OH)

Record details

NPI number1952897092
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 2, 2018
Last updated in NPPESFebruary 1, 2023
Certification dateFebruary 1, 2023

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