Provider Demographics
NPI:1063858165
Name:KAMARA, MABINTY A (LPN)
Entity Type:Individual
Prefix:
First Name:MABINTY
Middle Name:A
Last Name:KAMARA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 CRAWFORD FARMS DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9257
Mailing Address - Country:US
Mailing Address - Phone:614-620-0168
Mailing Address - Fax:
Practice Address - Street 1:7840 CRAWFORD FARMS DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9257
Practice Address - Country:US
Practice Address - Phone:614-620-0168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.426129163W00000X
OHCNP0033745163WP0807X
OHCNPOO33745364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent