Individual
MWINGI IDA LOMAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
2122 MANCHESTER EXPY, COLUMBUS, GA 31904-6878
(229) 402-4219
Mailing address
46 GASTON AVE, TIFTON, GA 31794-2075
(229) 402-4219
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
RN166752
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN166752
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366719197
—
GA
Enumeration date
11/22/2011
Last updated
07/12/2019
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