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Individual

MUKANDA MAMIE-CELINE MANSEKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
900 WYLIE RD SE, MARIETTA, GA 30067-7857
(770) 427-8727
Mailing address
PO BOX 1251, SMYRNA, GA 30081-1251
(470) 244-5601

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
269353
GA
363LF0000X
Family Nurse Practitioner
F11200019
GA

Other

Enumeration date
11/24/2020
Last updated
11/24/2020
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