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Individual

MISS AMINA BEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1110 13TH ST, COLUMBUS, GA 31901-2246
(706) 494-8900
(706) 494-8901
Mailing address
1110 13TH ST, COLUMBUS, GA 31901-2246
(706) 494-8900
(706) 494-8901

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN158807
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510444172
TAX ID
GA
Enumeration date
07/26/2016
Last updated
07/26/2016
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