Provider Demographics
NPI:1295426112
Name:MWANGI, STEPHEN N (RN)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:N
Last Name:MWANGI
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 1:1541 MIDDLESEX ST APT 9
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-1160
Mailing Address - Country:US
Mailing Address - Phone:978-942-1930
Mailing Address - Fax:
Practice Address - Street 1:1541 MIDDLESEX ST APT 9
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1160
Practice Address - Country:US
Practice Address - Phone:978-942-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN236025163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse