NPI Code Detail JSON Logo

1245638600 NPI number — TERI KOCH MSN, RN, FNP-BC

NPI Number: 1245638600
Health Care Provider/Practitioner: TERI KOCH MSN, RN, FNP-BC

Information about “1245638600” NPI (TERI KOCH MSN, RN, FNP-BC) exists in 1245638600 in HTML format HTML  |  1245638600 in plain Text format TXT  |  1245638600 in PDF (Portable Document Format) PDF  |  1245638600 in an XML format XML  formats.

NPI Number : 1245638600 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245638600",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KOCH",
    "FirstName": "TERI",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSN, RN, FNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BORYS",
    "OtherFirstName": "TERI",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MSN, RN, FNP-BC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 781076",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DETROIT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48278-1076",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-528-4800",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3283 WILLOWCREEK RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTAGE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46368-5054",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "219-764-8439",
    "PracticeLocationAddressFaxNumber": "219-764-8463",
    "EnumerationDate": "12/16/2014",
    "LastUpdateDate": "02/24/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "71005281A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.