Individual
MARIAM MUSTAPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
624 HENSON FARM DR, LOGANVILLE, GA 30052-6528
(678) 709-9828
Mailing address
624 HENSON FARM DR, LOGANVILLE, GA 30052-6528
(678) 709-9828
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN275428
GA
Other
Enumeration date
07/06/2023
Last updated
08/06/2025
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