Provider Demographics
NPI:1376264085
Name:NJERU, ELIZER MURANGI (LPN)
Entity Type:Individual
Prefix:
First Name:ELIZER
Middle Name:MURANGI
Last Name:NJERU
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:PO BOX 376
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-1017
Mailing Address - Country:US
Mailing Address - Phone:404-799-4145
Mailing Address - Fax:
Practice Address - Street 1:5610 CAVE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-3615
Practice Address - Country:US
Practice Address - Phone:770-882-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN091649164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse