Provider Demographics
NPI:1841788304
Name:MUTURI, STELLA WANJIRU (RN)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:WANJIRU
Last Name:MUTURI
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 1:1957 RIVERCHASE LN
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-6753
Mailing Address - Country:US
Mailing Address - Phone:214-477-8730
Mailing Address - Fax:
Practice Address - Street 1:1957 RIVERCHASE LN
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-6753
Practice Address - Country:US
Practice Address - Phone:214-477-8730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX770578163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse