MEDICARE: FANNY KAMARA NURSE (RN)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	426670	OH

General Provider Information

NPI Number	:	1336343003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FANNY KAMARA NURSE (RN)

Provider Business Mailing Address
First Line	:	3166 ZACH CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-5013
Country	:	US
Telephone Number	:	614-327-4344
Fax Number	:

Provider Business Practice Location Address
First Line	:	3166 ZACH CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-5013
Country	:	US
Telephone Number	:	614-327-4344
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	11/30/2016

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