Individual
RACHEL KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
24760 HOSPITAL DR, RED LAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Mailing address
24760 HOSPITAL DRIVE, RED LAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R129319-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289818700
—
MN
Enumeration date
06/06/2006
Last updated
09/19/2012
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