Provider Demographics
NPI:1932912995
Name:KOCH, SARA (PMHNP-BC APRN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KOCH
Suffix:
Gender:F
Credentials:PMHNP-BC APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22567-0086
Mailing Address - Country:US
Mailing Address - Phone:571-207-6829
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 86
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:VA
Practice Address - Zip Code:22567-0086
Practice Address - Country:US
Practice Address - Phone:571-839-5485
Practice Address - Fax:571-839-5485
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV122010363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health