Individual
SAMIRA OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
6117 MULBERRY STREET EXT, AUSTELL, GA 30168-4107
(470) 484-9377
Mailing address
6117 MULBERRY STREET EXT, AUSTELL, GA 30168-4107
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0030078606
GA
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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