Individual provider · NPI-1

Idrissatu Bah, NP

Nurse Practitioner · Newnan, GA

NPI number1083237069
StatusActive
Last updated in NPPESJun 6, 2023

Details

NPI
1083237069
Entity type
Individual (NPI-1)
Name
Idrissatu Bah
Credential
NP
Sex
Female
Sole proprietor
Yes
Enumeration date
May 25, 2020
Certification date
Jun 6, 2023
Last updated
Jun 6, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerRN224670GAYes
207Q00000X Family MedicineRN224670GA

Practice location

3116 Highway 34 E
Newnan, GA 30265-1342

Phone 404-948-3019

Mailing address

3905 Due West Rd Nw
Marietta, GA 30064-1019

Phone 678-290-5740

Other practice locations

3905 Due West Rd Nw
Marietta, GA 30064-1019

Phone 678-290-5740

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