Koucheravy, Grace

Koucheravy, Grace is an individual health care provider with primary practice located at 3720 Davinci Ct Suite 400, Norcross GA 30092-7627. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Koucheravy, Grace can be contacted via phone (770) 582-3992.

Contact Information

Primary practice address
3720 Davinci Ct Suite 400 Norcross GA 30092-7627
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN105205 Georgia

Profile Details

NPI number 1528048238
LBN Legal business name Koucheravy, Grace
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Nov 18th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1528048238 NPPES
Virginia MEDICAID 7789661

Popular Providers