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
Phone: (770) 582-3992
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528048238 | NPPES |
| Virginia | MEDICAID | 7789661 |
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