Samira Outlaw, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

CN0030078606 Issued in GA

Practice address

6117 Mulberry Street Ext
Austell, GA 30168-4107

Phone

(470) 484-9377

NPI assigned

Jan 27, 2023

Last updated

Jan 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1023724408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6117 MULBERRY STREET EXT",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301684107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6117 MULBERRY STREET EXT",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301684107",
            "telephone_number": "470-484-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "SAMIRA",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0030078606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Austell, GA
• Providers in Austell, GA by specialty
• Nurse's Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.