MEDICARE: CAROL MURUGI KIMANI NP

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	363LA2100X	Acute Care Nurse Practitioner	R255984	MD
2	363LA2100X	Acute Care Nurse Practitioner	95022714	CA

General Provider Information

NPI Number	:	1366153827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MURUGI KIMANI NP

Provider Business Mailing Address
First Line	:	1429 COOKSIE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-5209
Country	:	US
Telephone Number	:	410-992-2715
Fax Number	:

Provider Business Practice Location Address
First Line	:	802 LANDMARK DR
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-9100
Country	:	US
Telephone Number	:	410-863-4899
Fax Number	:

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

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	04/01/2025

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