Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 95006263 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 95006263 | CA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95006263 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 95006263 | CA |
NPI | 1376089219 |
---|---|
Provider Name | Andrew N Waireri |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93721-1324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2017 |
Last Update Date | 09/10/2020 |