IDA MAYAKA

MACON, GA
NPI1578160560
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: GA  RN194221)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: GA  F07191756)
Enumeration Date2020-10-03
Last Update Date2020-12-08
Business Address
IDA MAYAKA FNP
210 AUTUMN TRACE CT
MACON, GA 31210-8025
Phone number: 612-308-9012
Mailing Address
IDA MAYAKA FNP
210 AUTUMN TRACE CT
MACON, GA 31210-8025
Phone number: 612-308-9012