Koch, Tracey

Koch, Tracey is an individual health care provider with primary practice located at 420 N Second Ave Suite 100, Sandpoint ID 83864-1565. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Koch, Tracey can be contacted via phone (208) 265-2242.

Contact Information

Primary practice address
420 N Second Ave Suite 100 Sandpoint ID 83864-1565
Fax: (208) 265-8214
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X NP461A Idaho

Profile Details

NPI number 1295741239
LBN Legal business name Koch, Tracey
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jun 1st, 2012 - about 14 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 1295741239 NPPES
Idaho MEDICAID 806191100

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