Provider Demographics
NPI:1790453546
Name:POCHE, MERAB ANYANGO (CNA)
Entity Type:Individual
Prefix:MS
First Name:MERAB
Middle Name:ANYANGO
Last Name:POCHE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 BARRETT CREEK BLVD APT 1109
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-4968
Mailing Address - Country:US
Mailing Address - Phone:404-578-2959
Mailing Address - Fax:
Practice Address - Street 1:2400 BARRETT CREEK BLVD APT 1109
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-4968
Practice Address - Country:US
Practice Address - Phone:404-578-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-04
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0012884504376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide