Provider Demographics
NPI:1336343003
Name:KAMARA, FANNY (NURSE (RN))
Entity Type:Individual
Prefix:
First Name:FANNY
Middle Name:
Last Name:KAMARA
Suffix:
Gender:F
Credentials:NURSE (RN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 ZACH CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-5013
Mailing Address - Country:US
Mailing Address - Phone:614-327-4344
Mailing Address - Fax:
Practice Address - Street 1:3166 ZACH CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-5013
Practice Address - Country:US
Practice Address - Phone:614-327-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH426670163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse