Provider Demographics
NPI:1497542716
Name:MESAMOURS, YOUSELINE VALENCIA (NP)
Entity type:Individual
Prefix:
First Name:YOUSELINE
Middle Name:VALENCIA
Last Name:MESAMOURS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:YOUSELINE
Other - Middle Name:VALENCIA
Other - Last Name:MESAMOURS-SURLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2425 WESGATE DRIVE- SUITE 100
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707
Mailing Address - Country:US
Mailing Address - Phone:229-733-9488
Mailing Address - Fax:
Practice Address - Street 1:2205 E DOUBLEGATE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31721-9236
Practice Address - Country:US
Practice Address - Phone:229-603-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN252892207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine