Individual
VICTORIA KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
602 S 42ND ST, MOUNT VERNON, IL 62864-6264
(618) 899-3278
Mailing address
PO BOX 955860, SAINT LOUIS, MO 63195-1048
(636) 498-5944
(618) 443-1383
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2017038330
MO
363L00000X
Nurse Practitioner
Primary
209016821
IL
Other
Enumeration date
01/09/2018
Last updated
10/20/2020
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