Danielle Koch (NPI# 1275771370, PAC ID# 8022316777) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1275771370 |
| PAC ID by PECOS | 8022316777 |
| Professional Enrollment ID | I20170523002170 |
| Full Name | Danielle Koch |
| Organization Legal Name | CRYSTAL LAKE CLINIC PC |
| Address |
6170 Us Hwy 31 N Williamsburg MI 49690-9306 |
| Phone Number | 2316425556 |
| Gender | F |
| Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 0648259010 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230097 | MUNSON MEDICAL CENTER |
| 231301 | KALKASKA MEMORIAL HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6170 Us Hwy 31 N, Williamsburg, MI 49690-9306 | 2316425556 | CRYSTAL LAKE CLINIC PC |
| Organization Legal Name | CRYSTAL LAKE CLINIC PC |
| Physicians | 42 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Becky Lynn Porter | Nurse Practitioner | Crystal Lake Clinic PC | 115 E 7th St, Manton, MI 49663-9429 |
| Emily L Fader | Physician Assistant | Crystal Lake Clinic PC | 6227 Frankfort Hwy, Benzonia, MI 49616-8632 |
| Karen Lynn Volas | Nurse Practitioner | Crystal Lake Clinic PC | 1975 Stirling Dr, Interlochen, MI 49643-9264 |
| George B Ryckman | Family Medicine | Crystal Lake Clinic PC | 8225 Lake St, Bear Lake, MI 49614-9612 |
| Michael F Carroll | Family Medicine | Crystal Lake Clinic PC | 2283 E M, Suite 113, Kingsley, MI 49649-9370 |
| Maureen Street | Family Medicine | Crystal Lake Clinic PC | 124 Ames St, Elk Rapids, MI 49629-9449 |
| Tracy Robinson | Nurse Practitioner | Crystal Lake Clinic PC | 8225 Lake St, Bear Lake, MI 49614-9612 |
| Jacob Flynn | Family Medicine | Crystal Lake Clinic PC | 6227 Frankfort Hwy, Benzonia, MI 49616-8632 |
| Ryan A Sullivan | Internal Medicine | Crystal Lake Clinic PC | 8225 Lake St, Bear Lake, MI 49614-9612 |
| Michelle M Macdonald | Physician Assistant | Crystal Lake Clinic PC | 6227 Frankfort Hwy, Benzonia, MI 49616-8632 |
| Street Address |
6170 US HWY 31 N |
| City | WILLIAMSBURG |
| State | MI |
| Zip | 49690-9306 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Annelle M Kaspor | Nurse Practitioner | Crystal Lake Clinic PC | 6170 Us Hwy 31 N, Williamsburg, MI 49690-9306 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary Raymer | Clinical Social Worker | 6652 Deepwater Point Rd, Williamsburg, MI 49690-9247 | |
| Misten Boysen | Physical Therapy | 5782 Us Hwy 31 N, Williamsburg, MI 49690-9312 | |
| Jessica Jeannine Stallman | Chiropractic | 3875 M 72, Williamsburg, MI 49690-9359 | |
| Kara S Koeplin | Occupational Therapy | Balanced Home Therapy Solutions LLC | 3291 Kirkridge Dr, Williamsburg, MI 49690-9372 |
| Mark D Saunders | Dermatology | 3950 Shore Dr, Williamsburg, MI 49690-9548 |
| City | WILLIAMSBURG |
| Zip Code | 49690 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WILLIAMSBURG + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Danielle Koch.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.