Provider Demographics
NPI:1740096270
Name:KABIA, HABSATU AMINATA (PMHNP)
Entity type:Individual
Prefix:
First Name:HABSATU
Middle Name:AMINATA
Last Name:KABIA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10303 BALD HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2839
Mailing Address - Country:US
Mailing Address - Phone:240-704-3940
Mailing Address - Fax:240-387-6946
Practice Address - Street 1:10303 BALD HILL RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2839
Practice Address - Country:US
Practice Address - Phone:240-704-3940
Practice Address - Fax:240-387-6946
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2024072992363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health