Provider Demographics
NPI:1639661549
Name:KAMARA, MOHAMED ALHAJI (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:ALHAJI
Last Name:KAMARA
Suffix:
Gender:M
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 1:3450 TANTO CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5047
Mailing Address - Country:US
Mailing Address - Phone:702-487-0920
Mailing Address - Fax:
Practice Address - Street 1:6396 MCLEOD DR STE 9
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4429
Practice Address - Country:US
Practice Address - Phone:702-487-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN54830163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$Medicaid