Provider Demographics
NPI:1467792374
Name:GITAU, KAMAU P (CRNA)
Entity Type:Individual
Prefix:
First Name:KAMAU
Middle Name:P
Last Name:GITAU
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 N CAMPUS DR
Mailing Address - Street 2:B204
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-6379
Mailing Address - Country:US
Mailing Address - Phone:208-604-2938
Mailing Address - Fax:
Practice Address - Street 1:3501 N CAMPUS DR
Practice Address - Street 2:B204
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-6379
Practice Address - Country:US
Practice Address - Phone:208-604-2938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170675367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered