Provider Demographics
NPI:1104010123
Name:KOROMA, FINDA SEBBA (LVN)
Entity Type:Individual
Prefix:MS
First Name:FINDA
Middle Name:SEBBA
Last Name:KOROMA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 BURNET DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2696
Mailing Address - Country:US
Mailing Address - Phone:214-417-3529
Mailing Address - Fax:972-222-3196
Practice Address - Street 1:1045 BURNET DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-2696
Practice Address - Country:US
Practice Address - Phone:214-417-3529
Practice Address - Fax:972-222-3196
Is Sole Proprietor?:No
Enumeration Date:2007-09-03
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX190488164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse