Provider Demographics
NPI:1497972327
Name:KOCHER, BETHANY SUE
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:SUE
Last Name:KOCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2589 MERCER ST
Mailing Address - Street 2:
Mailing Address - City:SANDY LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:16145-3723
Mailing Address - Country:US
Mailing Address - Phone:724-376-7209
Mailing Address - Fax:
Practice Address - Street 1:2589 MERCER ST
Practice Address - Street 2:
Practice Address - City:SANDY LAKE
Practice Address - State:PA
Practice Address - Zip Code:16145-3723
Practice Address - Country:US
Practice Address - Phone:724-376-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN258930L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse