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1528741436
HAIKA GLORIA KISAMO
MARIETTA, GA
NPI
1528741436
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: GA RN270976)
Enumeration Date
2023-08-08
Last Update Date
2023-08-08
Business Address
HAIKA GLORIA KISAMO
811 KENNESAW AVE NW
MARIETTA, GA 30060-1002
Phone number: 770-422-2451
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Mailing Address
HAIKA GLORIA KISAMO
5323 WHITEHAVEN PARK LN SE
MABLETON, GA 30126-5957
Phone number: 832-818-0877
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