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Individual

MRS. JANE C KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2000 MON HEALTH MEDICAL PARK DR STE 2100, MORGANTOWN, WV 26505
(304) 599-6811
(304) 599-7159
Mailing address
2000 MON HEALTH MEDICAL PARK DR STE 2100, MORGANTOWN, WV 26505-1134
(304) 599-6811
(304) 599-7159

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
30529
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001710733
BCBS
WV
05
0092224000
WV
Enumeration date
04/11/2006
Last updated
08/14/2018
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