Provider Demographics
NPI:1093012585
Name:MWANGI, NANCY W (LPN)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:W
Last Name:MWANGI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 STAPLES AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-2242
Mailing Address - Country:US
Mailing Address - Phone:617-797-5610
Mailing Address - Fax:
Practice Address - Street 1:21 STAPLES AVE APT 11
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-2242
Practice Address - Country:US
Practice Address - Phone:617-797-5610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN85260164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse