Individual
MUSA MAWANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
404 STEVE DRIVE, RUSSELL SPRINGS, KY 42642-4622
(270) 866-3161
(270) 866-3163
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1693
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4016790
KY
Other
Enumeration date
04/28/2022
Last updated
11/08/2024
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