Healthcare Provider Details

I. General information

NPI: 1265825707
Provider Name (Legal Business Name): ASHLEY KOCH RN, BSN, AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY STREHLOW AGACNP

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12451 S 192ND ST
GRETNA NE
68028-4610
US

IV. Provider business mailing address

988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US

V. Phone/Fax

Practice location:
  • Phone: 402-332-3936
  • Fax: 402-408-2535
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number112244
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP7691
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number65369
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: