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General NPI Number Information
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NPI Number | 1821034281
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Entity Type | Individual
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Provider Name | ANDREA E KOCH WHNP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 10700 HIGHWAY 55
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City | PLYMOUTH
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State | MN
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Zip | 55441-6100
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Country | US
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Telephone | 952-213-2144
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Fax | 952-213-2184
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Provider Business Mailing Address
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Address Line | 10700 HIGHWAY 55
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City | PLYMOUTH
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State | MN
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Zip | 55441-6100
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Country | US
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Telephone | 952-213-2144
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | R1697315
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 2910
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License Number State | MN
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