Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 233029 | AZ |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 233029 | AZ |
N | 363LP2300X | Nurse Practitioner - Primary Care | 233029 | AZ |
NPI | 1184277139 |
---|---|
Provider Name | Norbert N Mwangi |
First Address | Phoenix, AZ 85066-8051 |
Second Address | Phoenix, AZ 85012-3313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2019 |
Last Update Date | 02/02/2021 |