Provider Demographics
NPI:1639880404
Name:MBIU, ESTHER WANJERI (FNP- BC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:WANJERI
Last Name:MBIU
Suffix:
Gender:F
Credentials:FNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1746
Mailing Address - Country:US
Mailing Address - Phone:317-430-3722
Mailing Address - Fax:
Practice Address - Street 1:3910 PEBBLE CREEK DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1746
Practice Address - Country:US
Practice Address - Phone:317-430-3722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28210276A363L00000X
KY1174710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner