Provider Demographics
NPI:1639997513
Name:KOCHER, AMANDA NICOLE (RD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE
Last Name:KOCHER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18106 E WILLIAMS BEND DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7690
Mailing Address - Country:US
Mailing Address - Phone:936-520-6277
Mailing Address - Fax:
Practice Address - Street 1:11412 SPRING CYPRESS RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-6523
Practice Address - Country:US
Practice Address - Phone:936-520-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83193133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered