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Individual

IDA MAYAKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
118 BYRD WAY STE 100, WARNER ROBINS, GA 31088-8038
(612) 308-9012
Mailing address
118 BYRD WAY STE 100, WARNER ROBINS, GA 31088-8038
(612) 308-9012

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F07191756
GA
363LF0000X
Family Nurse Practitioner
Primary
RN194221
GA

Other

Enumeration date
10/03/2020
Last updated
01/10/2025
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