Provider Demographics
NPI:1043537830
Name:GATHERU, ANNIE WAITHERA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:WAITHERA
Last Name:GATHERU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SUNDERLAND RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-2046
Mailing Address - Country:US
Mailing Address - Phone:508-363-0889
Mailing Address - Fax:508-363-0885
Practice Address - Street 1:425 SUNDERLAND RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2046
Practice Address - Country:US
Practice Address - Phone:508-363-0889
Practice Address - Fax:508-363-0885
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264630163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse