Individual
GRACE PEACE NIYONKURU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3480 WAKE FOREST RD STE 404, RALEIGH, NC 27609-7376
(919) 862-5730
Mailing address
2316 LANTERN WALK LN, WAKE FOREST, NC 27587-3411
(412) 805-6995
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5016698
NC
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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