Provider Demographics
NPI:1679180129
Name:NYABERI, ASENATH BONARERI
Entity Type:Individual
Prefix:
First Name:ASENATH
Middle Name:BONARERI
Last Name:NYABERI
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 1:3725 VAUCLUSE DR APT 36
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-7453
Mailing Address - Country:US
Mailing Address - Phone:682-558-2772
Mailing Address - Fax:
Practice Address - Street 1:3725 VAUCLUSE DR APT 36
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-7453
Practice Address - Country:US
Practice Address - Phone:682-558-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349636164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse