Healthcare Provider Details

I. General information

NPI: 1790567337
Provider Name (Legal Business Name): FATMATA KAMARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 SANDY SPRING RD # 300-W16
LAUREL MD
20707-3596
US

IV. Provider business mailing address

8101 SANDY SPRING RD # 300-W16
LAUREL MD
20707-3596
US

V. Phone/Fax

Practice location:
  • Phone: 240-716-4250
  • Fax: 240-823-6773
Mailing address:
  • Phone: 240-716-4250
  • Fax: 240-823-6773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR1887484
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberR187484
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR187484
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: