Provider Demographics
NPI:1265253132
Name:KAMARA, JENEBA
Entity type:Individual
Prefix:MRS
First Name:JENEBA
Middle Name:
Last Name:KAMARA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JENEBA
Other - Middle Name:
Other - Last Name:KAMARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JENEBA KAMARA
Mailing Address - Street 1:3639 WHARF LN
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-1056
Mailing Address - Country:US
Mailing Address - Phone:240-491-7086
Mailing Address - Fax:
Practice Address - Street 1:3639 WHARF LN
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-1056
Practice Address - Country:US
Practice Address - Phone:240-491-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA7859253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care