Provider Demographics
NPI:1598455040
Name:KINYUA, JOYCE WANGECHI
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:WANGECHI
Last Name:KINYUA
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 1:1900 BLUE OAKS BLVD APT 238
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8439
Mailing Address - Country:US
Mailing Address - Phone:913-548-2461
Mailing Address - Fax:
Practice Address - Street 1:1900 BLUE OAKS BLVD APT 238
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8439
Practice Address - Country:US
Practice Address - Phone:913-548-2461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95306239163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse