Healthcare Provider Details

I. General information

NPI: 1770932758
Provider Name (Legal Business Name): KRISTINA KOCH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 AMHERST ST
WINCHESTER VA
22601-2873
US

IV. Provider business mailing address

1870 AMHERST ST
WINCHESTER VA
22601-2873
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0102206523
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: