Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaissa Desta Idahosa, NP

Individual provider Nurse Practitioner · NPI 1942955323

Kaissa Desta Idahosa, NP is a Nurse Practitioner in Marietta, Georgia. Qualified in 2018, 8 years ago. Practices with Grady Memorial Hospital Corporation, a 363-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
8
Licensed in
GA
In the registry since
2022
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

2480 Windy Hill Rd SE
Marietta, GA 30067-8644
Phone: (800) 640-3451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN227597 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN227597 (GA)

Record details

NPI number1942955323
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedFebruary 15, 2022
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Grady Memorial Hospital Corporation — 363 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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