Provider Demographics
NPI:1467860858
Name:MWANGI, MOSES N (LPN)
Entity Type:Individual
Prefix:MR
First Name:MOSES
Middle Name:N
Last Name:MWANGI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MAYNARD ST APT 117
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3060
Mailing Address - Country:US
Mailing Address - Phone:508-369-3229
Mailing Address - Fax:
Practice Address - Street 1:50 MAYNARD ST APT 117
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3060
Practice Address - Country:US
Practice Address - Phone:508-369-3229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN67233164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse