Sovichearath Vann, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN201770 Issued in GA

Practice address

2759 Mount Zion Pkwy
Jonesboro, GA 30236-2568

Phone

(678) 289-8338

NPI assigned

Dec 17, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1811704257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SHOREHAM DR",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495846",
            "telephone_number": "404-944-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 MOUNT ZION PKWY",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362568",
            "telephone_number": "678-289-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANN",
        "first_name": "SOVICHEARATH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN201770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.