Individual
OLIVIA LISETTE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
536 N WEBSTER ST, PORT WASHINGTON, WI 53074-1538
(520) 508-1232
Mailing address
536 N WEBSTER ST, PORT WASHINGTON, WI 53074-1538
(520) 508-1232
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
18394-33
WI
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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