Provider Demographics
NPI:1508367806
Name:GITAU, HILDA WANJIKU (LVN)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:WANJIKU
Last Name:GITAU
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9655 CHIMNEY HILL LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2900
Mailing Address - Country:US
Mailing Address - Phone:254-349-1596
Mailing Address - Fax:
Practice Address - Street 1:9655 CHIMNEY HILL LN
Practice Address - Street 2:2005
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7524
Practice Address - Country:US
Practice Address - Phone:254-349-1596
Practice Address - Fax:254-349-1596
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307355164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse