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Individual

FATOUMATA DIARIOU KOUROUMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
340 EXCHANGE BLVD STE 120, BETHLEHEM, GA 30620-1759
(678) 963-7300
Mailing address
447 DUNAWAY CT, GRAYSON, GA 30017-2201
(203) 500-7823

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN297468
GA
363LF0000X
Family Nurse Practitioner
Primary
RN297468
GA

Other

Enumeration date
07/03/2023
Last updated
01/15/2025
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