Individual
KOCHURANI JACOB THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4915 CHARLESTOWN RD, NEW ALBANY, IN 47150-9426
(731) 394-1145
Mailing address
PO BOX 19599, BELFAST, ME 04915-4090
(731) 394-1145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012400A
IN
363LP2300X
Primary Care Nurse Practitioner
F12190904
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14532
ACS
—
Enumeration date
01/08/2020
Last updated
03/23/2022
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