Provider Demographics
NPI:1356057988
Name:KAMARA, ALPHA H (LPN)
Entity type:Individual
Prefix:
First Name:ALPHA
Middle Name:H
Last Name:KAMARA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 WINN WAY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1707
Mailing Address - Country:US
Mailing Address - Phone:404-683-4917
Mailing Address - Fax:
Practice Address - Street 1:4360 CONLEY LANDING
Practice Address - Street 2:DEKALB COUNTY
Practice Address - City:CONLEY
Practice Address - State:GA
Practice Address - Zip Code:30288
Practice Address - Country:US
Practice Address - Phone:140-468-3491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN078332164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse