Ugo Amalaha
Nurse Practitioner, Family in Austell, GA. Individual provider (NPI-1).
NPI number1104350701
StatusActive
Last updated in NPPESMay 16, 2024
Details
- NPI
- 1104350701
- Entity type
- Individual (NPI-1)
- Name
- Ugo Amalaha
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 20, 2017
- Certification date
- May 16, 2024
- Last updated
- May 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 229495 | GA | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | AP61411051 | WA |
Practice location
1846 S Carisbrook PlAustell, GA 30168-5139
Phone 770-313-8840
Mailing address
Po Box 335Smyrna, GA 30081-0335
Phone 770-313-8840
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