Provider Demographics
NPI:1457638538
Name:KUNGU, ROSEMARY MWALE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:MWALE
Last Name:KUNGU
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26703 EAGLE PARK LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1195
Mailing Address - Country:US
Mailing Address - Phone:713-385-4679
Mailing Address - Fax:
Practice Address - Street 1:1036 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-3336
Practice Address - Country:US
Practice Address - Phone:979-877-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily