Provider Demographics
NPI:1386100881
Name:TORMUSA-KOROMA, KUMBA PRISCILLA
Entity type:Individual
Prefix:
First Name:KUMBA
Middle Name:PRISCILLA
Last Name:TORMUSA-KOROMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6918 ITHACA HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2320
Mailing Address - Country:US
Mailing Address - Phone:832-677-2747
Mailing Address - Fax:
Practice Address - Street 1:6918 ITHACA HEIGHTS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2320
Practice Address - Country:US
Practice Address - Phone:832-677-2747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX759326163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics