Provider Demographics
NPI:1922317627
Name:KINYANJUI, SAMUEL MWANGI (LPN)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:MWANGI
Last Name:KINYANJUI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3856 JULIA CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4133
Mailing Address - Country:US
Mailing Address - Phone:614-316-0628
Mailing Address - Fax:
Practice Address - Street 1:3856 JULIA CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-4133
Practice Address - Country:US
Practice Address - Phone:614-316-0628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127496164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse