Provider Demographics
NPI:1831884576
Name:NGURE, ALICE WANJIKU
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:WANJIKU
Last Name:NGURE
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 1:5724 WYCKFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4040
Mailing Address - Country:US
Mailing Address - Phone:317-345-1405
Mailing Address - Fax:
Practice Address - Street 1:8250 BASH ST STE 26
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1792
Practice Address - Country:US
Practice Address - Phone:317-345-1405
Practice Address - Fax:317-798-1288
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28279839A163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Yes163W00000XNursing Service ProvidersRegistered Nurse