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Haika Gloria Kisamo
Primary Care Nurse Practitioner in Marietta, Georgia
NPI 1528741436

Haika Gloria Kisamo is a Primary Care Nurse Practitioner based in Mableton, GA and is specialized in Primary Care. Haika Gloria Kisamo practices in Marietta, GA. The NPI Number for Haika Gloria Kisamo is 1528741436 and holds a License No. RN270976 (Georgia).

The current practice location address for Haika Gloria Kisamo is 811 Kennesaw Ave Nw, Marietta, GA and can be reached out via phone at 770-422-2451.

Location: 811 Kennesaw Ave Nw, Marietta, GA, 30126-5957
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1528741436
Provider Name
Haika Gloria Kisamo
Credential
Provider Entity Type
Individual
Gender
Female
Address
811 Kennesaw Ave Nw, Marietta, GA, 30126-5957
Phone Number
770-422-2451
Fax Number
Provider Enumeration Date
08/08/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
811 Kennesaw Ave Nw
City
Marietta
State
Georgia
Zip
30060-1002
Phone Number
770-422-2451
Fax Number
person
Provider Business Mailing Address Details
Address
811 Kennesaw Ave Nw
City
Marietta
State
Georgia
Zip
30060-1002
Phone Number
770-422-2451
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
RN270976 (Georgia)
Definition
Definition to come...
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