Healthcare Provider Details

I. General information

NPI: 1083425599
Provider Name (Legal Business Name): WINROSE MAKENA MURIUKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ARIANNA LN
SAN RAMON CA
94582-3216
US

IV. Provider business mailing address

112 ARIANNA LN
SAN RAMON CA
94582-3216
US

V. Phone/Fax

Practice location:
  • Phone: 252-364-5948
  • Fax:
Mailing address:
  • Phone: 252-364-5948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN95300024
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License NumberRN95300024
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95300024
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN95300024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: