Provider Demographics
NPI:1477045755
Name:KIIRU, ESTHER (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:KIIRU
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 KATARINA LN
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7197
Mailing Address - Country:US
Mailing Address - Phone:916-718-0734
Mailing Address - Fax:
Practice Address - Street 1:335 KATARINA LN
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-7197
Practice Address - Country:US
Practice Address - Phone:916-718-0734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-03
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022035163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95022035OtherREGISTERED NURSE