Healthcare Provider Details

I. General information

NPI: 1174267173
Provider Name (Legal Business Name): VERONIKA GRECHANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 CREEKSHIRE WAY APT 347
WINSTON SALEM NC
27103-4055
US

IV. Provider business mailing address

1315 CREEKSHIRE WAY APT 347
WINSTON SALEM NC
27103-4055
US

V. Phone/Fax

Practice location:
  • Phone: 435-640-0601
  • Fax:
Mailing address:
  • Phone: 435-640-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number343770
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: