Individual provider · Type 1 NPI
Momona Woldemicael Samuel
Family Nurse Practitioner · Los Angeles, CA
NPI number
1124793419
Active
Practice location
808 W 58th St
Los Angeles, CA 90037-3632
Mailing address
4619 S Orcas St
Seattle, WA 98118-2432
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP61155406 (WA) |
| Family Nurse Practitioner Primary | 363LF0000X | 95018215 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124793419
Momona Woldemicael Samuel's National Provider Identifier is 1124793419, issued on Aug 10, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 31, 2021.