Provider Demographics
NPI:1073110334
Name:MAINGI, ROSEMARY MWELU
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:MWELU
Last Name:MAINGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24222 DANDELION CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-2741
Mailing Address - Country:US
Mailing Address - Phone:951-496-2936
Mailing Address - Fax:
Practice Address - Street 1:24222 DANDELION CT
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-2741
Practice Address - Country:US
Practice Address - Phone:951-496-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA816718163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical