Provider Demographics
NPI:1790492460
Name:MBUGUA, ESTHER (RN)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:MBUGUA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NISQUALLY CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5702
Mailing Address - Country:US
Mailing Address - Phone:240-852-9384
Mailing Address - Fax:888-447-5575
Practice Address - Street 1:2601 NISQUALLY CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5702
Practice Address - Country:US
Practice Address - Phone:240-852-9384
Practice Address - Fax:888-447-5575
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR184637163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5772498500Medicaid