Provider Demographics
NPI:1871072892
Name:TORKO, GRACE (LPN/OPERATOR)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:TORKO
Suffix:
Gender:F
Credentials:LPN/OPERATOR
Other - Prefix:
Other - First Name:GRACEFUL
Other - Middle Name:
Other - Last Name:HOME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN/OPERATOR
Mailing Address - Street 1:409 N CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-1663
Mailing Address - Country:US
Mailing Address - Phone:785-424-2785
Mailing Address - Fax:785-856-1091
Practice Address - Street 1:409 N CRESTLINE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-1663
Practice Address - Country:US
Practice Address - Phone:785-424-2785
Practice Address - Fax:785-856-1091
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251E00000X, 3747A0650X, 385H00000X, 385H00000X
KS131229163WH0200X
KS32039164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1730437997OtherHOME HEALTH
KS1730437997Medicaid
KS1871072892OtherHOME PLUS