Provider Demographics
NPI:1760115406
Name:GARBA, MARIAMA (CRNP)
Entity Type:Individual
Prefix:
First Name:MARIAMA
Middle Name:
Last Name:GARBA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARIAMA
Other - Middle Name:
Other - Last Name:GARBA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:106 WATERFORD PL
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-5002
Mailing Address - Country:US
Mailing Address - Phone:678-458-8790
Mailing Address - Fax:
Practice Address - Street 1:309 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5212
Practice Address - Country:US
Practice Address - Phone:256-490-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-151655363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner