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General NPI Number Information
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NPI Number | 1912322538
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Entity Type | Individual
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Provider Name | JENNIFER KAYE LANGE KOCH ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 405 S STATE ST
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City | HUBBARD
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State | IA
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Zip | 50122-9501
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Country | US
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Telephone | 641-864-3301
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Fax | 641-864-3304
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | HUBBARD
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State | IA
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Zip | 50122-0487
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Country | US
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Telephone | 641-864-3301
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Fax | 641-864-3304
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 114592
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 114592
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A114592
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License Number State | IA
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