Provider Demographics
NPI:1437837515
Name:ARUSEI, MIRIAM JEROTICH (RN)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:JEROTICH
Last Name:ARUSEI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21425 VANOWEN ST APT 633
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2775
Mailing Address - Country:US
Mailing Address - Phone:615-515-6641
Mailing Address - Fax:
Practice Address - Street 1:21425 VANOWEN ST APT 633
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2775
Practice Address - Country:US
Practice Address - Phone:615-515-6641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95149456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty