Doctor Name: | MICHELLE L KOCH-SHAMBURG |
NPI Number: | 1386740892 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP-C |
License Number: | MK1017626 |
Business Practice Address: | 800 Raven Hill Drive Atchison, KS - 66002 |
Business Phone Number: | 9133672131 |
Business Fax Number: | 9136742023 |
Mailing Address: | 800 Raven Hill Drive, ATCHISON |
State: | KS |
Postal Code: | 66002 |
Phone Number: | 9133672131 |
Fax Number: | 9136742023 |
NPI Enumeration Date: | 09/15/2006 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | MK1017626 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |