Provider Demographics
NPI:1750806758
Name:KAGWANJA, ROSEMARY NDUTA (MANAGER)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:NDUTA
Last Name:KAGWANJA
Suffix:
Gender:F
Credentials:MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 BERNINI AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2369
Mailing Address - Country:US
Mailing Address - Phone:520-820-8147
Mailing Address - Fax:520-820-8147
Practice Address - Street 1:425 BERNINI AVENUE
Practice Address - Street 2:N/A
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635
Practice Address - Country:US
Practice Address - Phone:520-820-8147
Practice Address - Fax:520-820-8147
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant