Provider Demographics
NPI:1780575266
Name:WAWERU, SUSAN NJOKI (RN, SRNA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:NJOKI
Last Name:WAWERU
Suffix:
Gender:F
Credentials:RN, SRNA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:NJOKI
Other - Last Name:MATHENGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:393 N GAY AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-6105
Mailing Address - Country:US
Mailing Address - Phone:678-517-3802
Mailing Address - Fax:
Practice Address - Street 1:4750 COLLEGIATE DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-1000
Practice Address - Country:US
Practice Address - Phone:850-872-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN261870163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool