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

Lassina Will Koidima, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1710548771

Lassina Will Koidima, AGACNP is a Nurse Practitioner in Statesboro, Georgia. Graduated from University of South Alabama College of Medicine in 2019, 7 years ago. Practices with Cogent Healthcare of Georgia PC, a 255-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Trained at
University of South Alabama College of Medicine
Licensed in
GA
In the registry since
2019
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Practice location Address checks out

1635 Pondside Dr
Statesboro, GA 30458-3777
Phone: (912) 507-9077
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1499 Fair Rd, Statesboro, GA 30458-1683 — (912) 486-1000

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence RN220878 (GA)

Record details

NPI number1710548771
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorYes
NPI enumeratedJune 21, 2019
Last updated in NPPESNovember 11, 2021
Certification dateNovember 11, 2021
Mailing address1635 Pondside Dr, Statesboro, GA 30458-3777

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Cogent Healthcare Of Georgia Pc — 255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Statesboro