Provider Demographics
NPI:1578127288
Name:KAMARA, AMINATA SANKOH (NP)
Entity Type:Individual
Prefix:
First Name:AMINATA
Middle Name:SANKOH
Last Name:KAMARA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19TH 8TH STREET SOUTH
Mailing Address - Street 2:PMB 424
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1804
Mailing Address - Country:US
Mailing Address - Phone:701-660-3006
Mailing Address - Fax:701-660-3391
Practice Address - Street 1:19TH 8TH STREET SOUTH
Practice Address - Street 2:PMB 424
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1804
Practice Address - Country:US
Practice Address - Phone:701-660-3006
Practice Address - Fax:701-660-3391
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDF06192940363LF0000X
MN2021208910363LP0808X
NDR41081363LP2300X
MN7825363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care