Provider Demographics
NPI:1932868510
Name:MWAURA, PATRICK WAWERU (RN)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:WAWERU
Last Name:MWAURA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 YORK ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4936
Mailing Address - Country:US
Mailing Address - Phone:978-655-0500
Mailing Address - Fax:
Practice Address - Street 1:2367 TACOMA AVE S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1409
Practice Address - Country:US
Practice Address - Phone:617-663-0663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61223205163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty