Organization
LEADETH STILLWATERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATIMA MUNA KOROMA NP (CEO)
(571) 277-1111
Entity
Organization
Contact information
Practice address
712 H ST NE STE 1628, WASHINGTON, DC 20002-3627
(301) 265-5922
Mailing address
9461 CHARLEVILLE BLVD STE 1216, BEVERLY HILLS, CA 90212-3017
(301) 265-5922
(475) 275-7541
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/20/2022
Last updated
06/05/2026
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