Individual
STACY KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CCRN
Contact information
Practice address
9665 ROCKY PT, CLARENCE, NY 14031-1588
(716) 759-7717
Mailing address
9665 ROCKY PT, CLARENCE, NY 14031-1588
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
118382
NY
Other
Enumeration date
12/08/2015
Last updated
05/23/2019
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