Individual provider · Type 1 NPI

Kaissa Desta Idahosa, NP

Family Nurse Practitioner · Marietta, GA

NPI number 1942955323 Active

Practice location

2480 Windy Hill Rd SE
Marietta, GA 30067-8644

Mailing address

PO Box 1200
Pleasant Grove, UT 84062-1200

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000XRN227597 (GA)
Family Nurse Practitioner Primary 363LF0000XRN227597 (GA)

Family Nurse Practitioner: Definition to come...

12 other providers at this address

Other family nurse practitioner providers in Marietta

See all in Marietta →

About NPI 1942955323

Kaissa Desta Idahosa, NP's National Provider Identifier is 1942955323, issued on Feb 15, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Marietta, GA. The record was last updated on Oct 3, 2024.