Koch, Myranda

Koch, Myranda is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Koch, Myranda can be contacted via phone (414) 805-3666.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 805-3666
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 8724 Wisconsin

Profile Details

NPI number 1336615129
LBN Legal business name Koch, Myranda
Credentials APNP, DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2018
Last updated Nov 7th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336615129 NPPES
Wisconsin MEDICAID 1336615129

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