Individual
KAYLA DAWN KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4617 CONESTOGA TRL, COTTAGE GROVE, WI 53527-9666
(608) 212-8365
Mailing address
4617 CONESTOGA TRL, COTTAGE GROVE, WI 53527-9666
(608) 212-8365
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
244307-30
WI
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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