Provider Demographics
NPI:1750011409
Name:KARURU, TSUNGIRAI
Entity Type:Individual
Prefix:
First Name:TSUNGIRAI
Middle Name:
Last Name:KARURU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TSUNGIRAI
Other - Middle Name:
Other - Last Name:MAKARUTSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:399 WALKER ST APT 15
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2536
Mailing Address - Country:US
Mailing Address - Phone:978-758-2850
Mailing Address - Fax:
Practice Address - Street 1:399 WALKER ST APT 15
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2536
Practice Address - Country:US
Practice Address - Phone:978-758-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN98978164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse