Healthcare Provider Details

I. General information

NPI: 1629843222
Provider Name (Legal Business Name): NICOLE KOCHMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2023
Last Update Date: 08/20/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL RD
CHEROKEE NC
28719
US

IV. Provider business mailing address

1 HOSPITAL RD
CHEROKEE NC
28719
US

V. Phone/Fax

Practice location:
  • Phone: 828-497-9163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4961661
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: