Provider Demographics
NPI:1609522408
Name:KAMARA, FATMATA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:FATMATA
Middle Name:
Last Name:KAMARA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CONSTITUTION AVE APT 348
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-5083
Mailing Address - Country:US
Mailing Address - Phone:302-883-9257
Mailing Address - Fax:
Practice Address - Street 1:344 GROVE ST # 4139
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-5923
Practice Address - Country:US
Practice Address - Phone:302-883-9257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR23898400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse