Provider Demographics
NPI:1093980245
Name:MACHARIA, ROSEMARY WAMAITHA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:WAMAITHA
Last Name:MACHARIA
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 W. MAPLE ST.
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050
Mailing Address - Country:US
Mailing Address - Phone:816-521-5316
Mailing Address - Fax:
Practice Address - Street 1:201 N FOREST AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-2513
Practice Address - Country:US
Practice Address - Phone:512-423-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMM2593689OtherDEA
KSMM2616831OtherDEA
MOMA1521010Medicare PIN
MOMM2593689OtherDEA