Provider Demographics
NPI:1609213685
Name:KARIUKI, SAMUEL KAMAU (LPN)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:KAMAU
Last Name:KARIUKI
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 1:22 DOUGLAS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2849
Mailing Address - Country:US
Mailing Address - Phone:508-723-6917
Mailing Address - Fax:
Practice Address - Street 1:22 DOUGLAS ST APT 1
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2849
Practice Address - Country:US
Practice Address - Phone:508-723-6917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN68649164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse