Provider Demographics
NPI:1134685654
Name:KAMARA, MABINTI (FNP-C)
Entity Type:Individual
Prefix:
First Name:MABINTI
Middle Name:
Last Name:KAMARA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12770 RIPPLE CREEK CT APT 2314
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6562
Mailing Address - Country:US
Mailing Address - Phone:703-861-8038
Mailing Address - Fax:
Practice Address - Street 1:12770 RIPPLE CREEK CT APT 2314
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6562
Practice Address - Country:US
Practice Address - Phone:703-861-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty