Provider Demographics
NPI:1164176954
Name:KOCH, SONJA (BS, BSN, RN, WCC)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:KOCH
Suffix:
Gender:F
Credentials:BS, BSN, RN, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 VIENNA PKWY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-1486
Mailing Address - Country:US
Mailing Address - Phone:937-741-7896
Mailing Address - Fax:
Practice Address - Street 1:2510 VIENNA PKWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-1486
Practice Address - Country:US
Practice Address - Phone:937-741-7896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.411359163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse