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NPI Code Detail

MEDICARE: RACHAEL LEE KOCH CRNP

MEDICARE: RACHAEL LEE KOCH CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner22135TN
2363L00000XNurse PractitionerSP021946PA

General Provider Information

NPI Number : 1740714294
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL LEE KOCH CRNP
Provider Business Mailing Address
First Line : 3530 RIVER RD
Second Line :
City : WATSONTOWN
State : PA
Zip : 17777-8658
Country : US
Telephone Number : 570-837-2123
Fax Number : 570-837-2185
Provider Business Practice Location Address
First Line : 471 HEPBURN ST
Second Line :
City : WILLIAMSPORT
State : PA
Zip : 17701-6122
Country : US
Telephone Number : 570-567-5400
Fax Number : 877-551-9931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2017
Last Update Date : 02/04/2026

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