Individual
KIMBERLY POREMBA KOCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4600 W LOOMIS RD, GREENFIELD, WI 53220-4858
(414) 281-4466
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3325
WI
363AS0400X
Surgical Physician Assistant
7918
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100038637
—
WI
Enumeration date
07/03/2014
Last updated
05/04/2023
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