Individual
ANDREW KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 369-8000
Mailing address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN692480
PA
163WE0003X
Emergency Registered Nurse
0988255
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024189251
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/16/2021
Last updated
01/29/2024
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