Provider Demographics
NPI:1356031058
Name:MAINA, MARION ANNE NYAWIRA
Entity type:Individual
Prefix:MISS
First Name:MARION ANNE
Middle Name:NYAWIRA
Last Name:MAINA
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 1:15152 KENTSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4063
Mailing Address - Country:US
Mailing Address - Phone:206-627-7121
Mailing Address - Fax:
Practice Address - Street 1:15152 KENTSHIRE DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4063
Practice Address - Country:US
Practice Address - Phone:206-627-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401221420376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide