Provider Demographics
NPI:1649428236
Name:WAINAINA, PENINAH NDUTA
Entity type:Individual
Prefix:
First Name:PENINAH
Middle Name:NDUTA
Last Name:WAINAINA
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 1:103 HILL ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3708
Mailing Address - Country:US
Mailing Address - Phone:781-632-5455
Mailing Address - Fax:
Practice Address - Street 1:103 HILL ST
Practice Address - Street 2:SUITE 2
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3708
Practice Address - Country:US
Practice Address - Phone:781-632-5455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278974163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health