Provider Demographics
NPI:1073378162
Name:DAMIANI-GROCHOWSKI, LUANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:DAMIANI-GROCHOWSKI
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 WAKE FOREST RD STE 349
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-0010
Mailing Address - Country:US
Mailing Address - Phone:910-629-5344
Mailing Address - Fax:
Practice Address - Street 1:2310 S MIAMI BLVD STE 141
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4900
Practice Address - Country:US
Practice Address - Phone:910-629-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019730363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner