Doctor Name: | GLORIA DIANE KOCHIS |
NPI Number: | 1699744250 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N., WHNP |
License Number: | MO-096364 |
Business Practice Address: | 1025 W Main St Park Hills, MO - 636012079 |
Business Phone Number: | 5734311947 |
Business Fax Number: | 5734317326 |
Mailing Address: | Po Box Q, PARK HILLS |
State: | MO |
Postal Code: | 636010397 |
Phone Number: | 5734311947 |
Fax Number: | 5734317326 |
NPI Enumeration Date: | 03/16/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | MO-096364 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |