Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 209.017024 | IL |
NPI | 1023524485 |
---|---|
Provider Name | Nancy Sarudzayi Kinyanjui |
First Address | Arlington Heights, IL 60004-4602 |
Second Address | Arlington Heights, IL 60004-4602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2017 |
Last Update Date | 02/03/2020 |