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NPI 1770296725

NPI 1770296725 : NYAMBURA KURIA : ELLENWOOD, GA

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General NPI Number Information
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    NPI Number           |    1770296725
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    Entity Type          |    Individual 
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    Provider Name        |    NYAMBURA KURIA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/04/2023
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    Last Update Date     |    01/04/2023
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Provider Practice Location Address
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    Address Line         |    3975 COURTNEY PL 
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    City                 |    ELLENWOOD
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    State                |    GA
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    Zip                  |    30294-4225
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    Country              |    US
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    Telephone            |    770-866-0876
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3975 COURTNEY PL 
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    City                 |    ELLENWOOD
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    State                |    GA
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    Zip                  |    30294-4225
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    Country              |    US
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    Telephone            |    770-866-0876
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    RN256285
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    License Number State |    GA
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