Provider Demographics
NPI:1831801406
Name:KAMAU, GRACE MUMBI (NP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:MUMBI
Last Name:KAMAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-0123
Mailing Address - Country:US
Mailing Address - Phone:434-404-4728
Mailing Address - Fax:
Practice Address - Street 1:508 7TH STREET
Practice Address - Street 2:
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517
Practice Address - Country:US
Practice Address - Phone:434-404-4728
Practice Address - Fax:434-234-8978
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186279363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health