| Nimba Integrative Practice Llc Stone Mountain | |
|
5300 Memorial Dr Ste 101 Stone Mountain GA 30083-3154 | |
| (470) 918-9719 | |
| Not Available |
| Full Name | Nimba Integrative Practice Llc Stone Mountain |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 5300 Memorial Dr Ste 101, Stone Mountain, Georgia |
| Authorized Official Name and Position | Asata Kamara Aprn (OWNER) |
| Authorized Official Contact | 4709189719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nimba Integrative Practice Llc Stone Mountain 5300 Memorial Dr Ste 101 Stone Mountain GA 30083-3154 Ph: () - | Nimba Integrative Practice Llc Stone Mountain 5300 Memorial Dr Ste 101 Stone Mountain GA 30083-3154 Ph: (470) 918-9719 |
| NPI Number | 1902591472 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 10/11/2023 |
| Medicare PECOS PAC ID | 4183082431 |
|---|---|
| Medicare Enrollment ID | O20230620001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902591472 | NPI | - | NPPES |
| Provider Name | Asata Kamara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124412788 PECOS PAC ID: 4688956493 Enrollment ID: I20170131000131 |
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