Basic Information
| Provider Information | |||||||||
| NPI: | 1457682296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOCHER | ||||||||
| FirstName: | SHEILA | ||||||||
| MiddleName: | KAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2707 E 21ST ST N | ||||||||
| Address2: | PO BOX 239 | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672142249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166910249 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2707 E 21ST ST N | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672142249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166910249 | ||||||||
| FaxNumber: | 3166919875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2010 | ||||||||
| LastUpdateDate: | 02/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LC1500X | 5374964041 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Community Health |
ID Information
| ID | Type | State | Issuer | Description | 100321990D | 05 | KS | MEDICAID |