Provider Demographics
NPI:1477177483
Name:KAMARA, MARIATU (LPN)
Entity Type:Individual
Prefix:
First Name:MARIATU
Middle Name:
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 1:351 HUNTLEY RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-3803
Mailing Address - Country:US
Mailing Address - Phone:215-254-8044
Mailing Address - Fax:484-388-4875
Practice Address - Street 1:351 HUNTLEY RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3803
Practice Address - Country:US
Practice Address - Phone:215-254-8044
Practice Address - Fax:484-388-4875
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN289618164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse