Provider Demographics
NPI:1326816596
Name:KAMARA, BRIMA (LPN)
Entity Type:Individual
Prefix:
First Name:BRIMA
Middle Name:
Last Name:KAMARA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 W DESERT HILLS DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85144-6434
Mailing Address - Country:US
Mailing Address - Phone:215-917-4216
Mailing Address - Fax:
Practice Address - Street 1:3560 E DAKOTA DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-1721
Practice Address - Country:US
Practice Address - Phone:215-917-4216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ276986164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse