Basic Information
| Provider Information | |||||||||
| NPI: | 1629306766 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOCH | ||||||||
| FirstName: | MEGHAN | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3651 COLLEGE BLVD | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133197600 | ||||||||
| FaxNumber: | 9132531704 | ||||||||
| Practice Location | |||||||||
| Address1: | 4940B W. 137TH ST. | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662245912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132329846 | ||||||||
| FaxNumber: | 9132329817 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 363LF0000X | 75022 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.