Provider Demographics
NPI:1912495300
Name:NDIRANGU, JANE W
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:W
Last Name:NDIRANGU
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 1:4520 FOREST BEND CT
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2706
Mailing Address - Country:US
Mailing Address - Phone:617-820-3655
Mailing Address - Fax:
Practice Address - Street 1:4520 FOREST BEND CT
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2706
Practice Address - Country:US
Practice Address - Phone:617-820-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX324332164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse