Provider Demographics
NPI:1912525171
Name:CHOE, GRACE SHIM (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:SHIM
Last Name:CHOE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 PISA DR APT 1432
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-2153
Mailing Address - Country:US
Mailing Address - Phone:813-486-3367
Mailing Address - Fax:
Practice Address - Street 1:8601 PISA DR APT 1432
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-2153
Practice Address - Country:US
Practice Address - Phone:813-486-3367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily