Provider Demographics
NPI:1023411956
Name:KAMARA, MUMMY
Entity type:Individual
Prefix:
First Name:MUMMY
Middle Name:
Last Name:KAMARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8531A GREENBELT RD
Mailing Address - Street 2:APT. 102
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2323
Mailing Address - Country:US
Mailing Address - Phone:301-377-6243
Mailing Address - Fax:
Practice Address - Street 1:8531A GREENBELT RD
Practice Address - Street 2:APT. 102
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2323
Practice Address - Country:US
Practice Address - Phone:301-377-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1006651164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse