GRACE KOUCHERAVY FNP NPI 1528048238

NPI Information

NPI: 1528048238
Provider Name: GRACE KOUCHERAVY, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
3720 DAVINCI CT
SUITE 400
NORCROSS, GA
ZIP 30092
Phone: (770) 582-3992
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Grace Koucheravy, FNP is a family nurse practitioner in Norcross, GA. Grace Koucheravy, FNP NPI is 1528048238. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3720 DAVINCI CT
SUITE 400
NORCROSS, GA
ZIP 30092-627
Phone: (770) 582-3992

The enumeration date for this NPI number is 1/19/2006 and was last updated on 11/18/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN105205	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7789661	MEDICAID	VIRGINIA
2	S65484	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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