Healthcare Provider Details

I. General information

NPI: 1093410789
Provider Name (Legal Business Name): FATMATA SORIE KAMARA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 PENNSYLVANIA AVE SE STE LL
WASHINGTON DC
20020-3865
US

IV. Provider business mailing address

5290 SHAWNEE RD STE 209
ALEXANDRIA VA
22312-2377
US

V. Phone/Fax

Practice location:
  • Phone: 202-894-6811
  • Fax:
Mailing address:
  • Phone: 571-265-5969
  • Fax: 703-991-8557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024195854
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP500005866
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: