Individual
DENISE NABOURO SAMASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3354 PRESERVE RUN TRL, LOGANVILLE, GA 30052-8305
(646) 639-3991
Mailing address
3354 PRESERVE RUN TRL, LOGANVILLE, GA 30052-8305
(646) 639-3991
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN297534
GA
Other
Enumeration date
12/24/2024
Last updated
12/24/2024
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