Provider Demographics
NPI:1396126710
Name:KOCHER, LYNNIECE A (DO)
Entity type:Individual
Prefix:
First Name:LYNNIECE
Middle Name:A
Last Name:KOCHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LYNNIECE
Other - Middle Name:A
Other - Last Name:DUNBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-426-9565
Mailing Address - Fax:812-426-9572
Practice Address - Street 1:8600 N KENTUCKY AVENUE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47722
Practice Address - Country:US
Practice Address - Phone:812-426-9565
Practice Address - Fax:812-426-9572
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11018352A207Q00000X
IN02004919A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201295580Medicaid