LASSINA WILL KOIDIMA (NPI# 1710548771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710548771 |
| Entity Type | Individual |
| Full Name | LASSINA WILL KOIDIMA |
| Credential | AGACNP |
| Practice Address |
1635 Pondside Dr Statesboro GA 30458-3777 |
| Practice Telephone | 9125079077 |
| Mailing Telephone | 9125079077 |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN220878 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1635 PONDSIDE DR |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-3777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609437359 | Whitney Laney Jones | Nurse Practitioner | 112 Raleigh Ct, Statesboro, GA 30458-0160 | 2019-06-24 |
| 1881188779 | Shana Danielle Hutto | Nurse Practitioner | 1497 Fair Rd Ste 305, Statesboro, GA 30458-0828 | 2018-06-14 |
| 1316467467 | Stephanie Lindamood | Nurse Practitioner | 1499 Fair Rd, Statesboro, GA 30458-1683 | 2017-06-20 |
| 1598155004 | Tiffany Kreun | Nurse Practitioner | 1601 Fair Rd, Suite 600, Statesboro, GA 30458-1698 | 2015-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032114 | Candace Buckley | Nurse Practitioner | 244 Ashland Dr, Woodstock, GA 30189-7161 | 2020-10-29 |
| 1679170740 | Jennifer Lassiter | Nurse Practitioner | 4116 Holley Rd., Lizella, GA 31052 | 2020-10-02 |
| 1891301164 | Tashoy Wallace | Nurse Practitioner | 121 Odyssey Turn, Conyers, GA 30012-3681 | 2020-09-21 |
| 1912513672 | Katherine Anne Sego | Nurse Practitioner | 4060 Rolling Meadows Ln, Watkinsville, GA 30677-3011 | 2020-09-18 |
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1588276505 | Sherron Johnson | Nurse Practitioner | 1980 Wrights Way, Jonesboro, GA 30236-7205 | 2020-08-20 |
| 1942811682 | Ashlee Renee Mack | Nurse Practitioner | 116 Slate Cir, Savannah, GA 31419-9681 | 2020-08-16 |
| 1467063610 | Rosa Maria Phillips | Nurse Practitioner | 649 Amicalola Woods Rd, Dawsonville, GA 30534-1205 | 2020-08-12 |
| 1508476581 | Jarvis Reese | Nurse Practitioner | 413 Tug Ct, Warner Robins, GA 31088-2134 | 2020-08-05 |
| 1750991790 | Akosua Frema Sarfo | Nurse Practitioner | 116 Ginkgo Ln, Grovetown, GA 30813-5392 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
Please comment or provide details below to improve the information on LASSINA WILL KOIDIMA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.