Provider Demographics
NPI:1649996455
Name:KIMANI, DAVID WAINAINA (FNP-NP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WAINAINA
Last Name:KIMANI
Suffix:
Gender:M
Credentials:FNP-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 MILLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9250
Mailing Address - Country:US
Mailing Address - Phone:316-251-2548
Mailing Address - Fax:
Practice Address - Street 1:6020 MILLBROOK ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66218-9250
Practice Address - Country:US
Practice Address - Phone:316-251-2548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS80470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily