Provider Demographics
NPI:1891380655
Name:NJOROGE, ALICE WANGUI (NP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:WANGUI
Last Name:NJOROGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15967 S AVALON ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2500
Mailing Address - Country:US
Mailing Address - Phone:913-378-6795
Mailing Address - Fax:
Practice Address - Street 1:15967 S AVALON ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2500
Practice Address - Country:US
Practice Address - Phone:913-378-6795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79836-122207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine