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Individual

THERESE K KOCH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MSW, CNN, APRN-C

Contact information

Practice address
201 LAUREL OAK RD, SUITE B, VOORHEES, NJ 08043-4424
(856) 566-5478
(856) 566-9561
Mailing address
38 BON AIR DR, MARLTON, NJ 08053-1867
(856) 596-2053

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00040100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0013234
NJ
Enumeration date
05/30/2006
Last updated
07/08/2007
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