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NPI Code Detail

MEDICARE: GRACE CHELANGAT KORIR

MEDICARE: GRACE CHELANGAT KORIR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363LP0808XPsychiatric/Mental Health Nurse Practitioner5017643NC

General Provider Information

NPI Number : 1952035248
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE CHELANGAT KORIR
Provider Business Mailing Address
First Line : 3 TINSBURY PL
Second Line :
City : DURHAM
State : NC
Zip : 27713-6517
Country : US
Telephone Number : 919-768-3655
Fax Number :
Provider Business Practice Location Address
First Line : 104 NEW STATESIDE DR
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27516-1213
Country : US
Telephone Number : 919-768-3655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2022
Last Update Date : 02/17/2023

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Directions to “ GRACE CHELANGAT KORIR ” Practice Location

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