Provider Demographics
NPI:1417449927
Name:KIRAGU, PAULINE WANJIRU
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:WANJIRU
Last Name:KIRAGU
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 1:904 SUNDROP DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5174
Mailing Address - Country:US
Mailing Address - Phone:214-603-1829
Mailing Address - Fax:
Practice Address - Street 1:904 SUNDROP DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5174
Practice Address - Country:US
Practice Address - Phone:214-603-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX874622163W00000X
TX1156729363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse