MEDICARE: LEAH WANJIRU NGURE RN, MSN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	22865	CA
2	363LP2300X	Primary Care Nurse Practitioner	22865	CA

General Provider Information

NPI Number	:	1255764080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH WANJIRU NGURE RN, MSN, FNP-C

Provider Business Mailing Address
First Line	:	520 E TEMPLE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-4024
Country	:	US
Telephone Number	:	213-356-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 E TEMPLE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-4024
Country	:	US
Telephone Number	:	213-356-3750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2013
Last Update Date	:	08/30/2017

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