Provider Demographics
NPI:1336915164
Name:MUEMA, MONICAH MUTUO
Entity Type:Individual
Prefix:MRS
First Name:MONICAH
Middle Name:MUTUO
Last Name:MUEMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 MARTWAY CIR APT A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5815
Mailing Address - Country:US
Mailing Address - Phone:913-548-1404
Mailing Address - Fax:
Practice Address - Street 1:1421 MARTWAY CIR APT A
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5815
Practice Address - Country:US
Practice Address - Phone:913-548-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS126176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse