Provider Demographics
NPI:1013523646
Name:KAMAU, SUSAN WANJIKU (FNP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:WANJIKU
Last Name:KAMAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:WANJIKU
Other - Last Name:KAMAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1579 SAGE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5327
Mailing Address - Country:US
Mailing Address - Phone:404-643-0444
Mailing Address - Fax:
Practice Address - Street 1:1579 SAGE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5327
Practice Address - Country:US
Practice Address - Phone:404-643-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN251277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily