| NPI | 1669917688 |
|---|---|
| Former Name | DEANNA LYNN KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 78168) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016044689) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2022-03-08 |