Provider Demographics
NPI:1851967525
Name:MWANGI, NICHOLAS GICHUKI (APN)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:GICHUKI
Last Name:MWANGI
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HOY AVE
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-1942
Mailing Address - Country:US
Mailing Address - Phone:732-986-7389
Mailing Address - Fax:
Practice Address - Street 1:195 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1755
Practice Address - Country:US
Practice Address - Phone:973-295-6335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01147600163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health