Provider Demographics
NPI:1952714537
Name:NGUGI, ROSEMARY WAMBUI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:WAMBUI
Last Name:NGUGI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:3221 NANDINA STREET
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2667
Mailing Address - Country:US
Mailing Address - Phone:978-319-7840
Mailing Address - Fax:469-931-0282
Practice Address - Street 1:3221 NANDINA STREET
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2667
Practice Address - Country:US
Practice Address - Phone:978-319-7840
Practice Address - Fax:469-931-0282
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX865004163W00000X
MARN2273461163WP0808X
AZ303228363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303287OtherMBHP
MA1004745OtherNHP
MA1303287Medicaid
MA99618201OtherNETWORK HEALTH
MA042611055OtherTAV ID
MA0000023532OtherBMC
MAM18633OtherBCBS
MA042611055OtherTAV ID