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General NPI Number Information
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NPI Number | 1902540578
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Entity Type | Individual
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Provider Name | NAWA EMMANUELLA KAMATE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 01/29/2023
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Provider Practice Location Address
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Address Line | 2431 SANDTOWN RD SW
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City | MARIETTA
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State | GA
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Zip | 30060-6660
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Country | US
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Telephone | 720-314-8734
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Fax |
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Provider Business Mailing Address
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Address Line | 906 LISMORE SE
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City | SMYRNA
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State | GA
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Zip | 30080-8518
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Country | US
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Telephone | 720-314-8734
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F03220375
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN259271
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License Number State | GA
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