Provider Demographics
NPI:1821773649
Name:MUIRURI, ANNAH WAIRIMU (LVN)
Entity Type:Individual
Prefix:
First Name:ANNAH
Middle Name:WAIRIMU
Last Name:MUIRURI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13939 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:CLEARLAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95422-9514
Mailing Address - Country:US
Mailing Address - Phone:831-265-3441
Mailing Address - Fax:
Practice Address - Street 1:13939 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422-9514
Practice Address - Country:US
Practice Address - Phone:831-265-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229039164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse