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Individual

GRACE KIM KOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
514 W MAPLE ST STE 306, CUMMING, GA 30040-2420
(678) 455-9885
(678) 455-9885
Mailing address
514 W MAPLE ST, STE 306, CUMMING, GA 30040-2420
(678) 455-9882
(678) 455-9885

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024171736
VA
363LF0000X
Family Nurse Practitioner
18490
TN
363LF0000X
Family Nurse Practitioner
Primary
RN218400
GA

Other

Enumeration date
03/29/2013
Last updated
11/05/2019
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