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General NPI Number Information
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NPI Number | 1740714294
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Entity Type | Individual
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Provider Name | RACHAEL LEE KOCH CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 471 HEPBURN ST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-6122
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Country | US
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Telephone | 570-567-5400
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Fax | 877-551-9931
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Provider Business Mailing Address
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Address Line | 3530 RIVER RD
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City | WATSONTOWN
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State | PA
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Zip | 17777-8658
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Country | US
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Telephone | 570-837-2123
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Fax | 570-837-2185
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22135
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP021946
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License Number State | PA
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