Provider Demographics
NPI:1255008876
Name:MUKIRA, ROSEMARY WANGARI (RN)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:WANGARI
Last Name:MUKIRA
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 1:4910 GILRAY DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2134
Mailing Address - Country:US
Mailing Address - Phone:410-718-2065
Mailing Address - Fax:
Practice Address - Street 1:4910 GILRAY DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2134
Practice Address - Country:US
Practice Address - Phone:410-718-2065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197124163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation