Healthcare Provider Details

I. General information

NPI: 1467161794
Provider Name (Legal Business Name): MONICA MUIRURI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 GROVE ST STE 307-310
WORCESTER MA
01605-2651
US

IV. Provider business mailing address

11 EASTVIEW DR
WORCESTER MA
01602-5104
US

V. Phone/Fax

Practice location:
  • Phone: 774-391-8946
  • Fax:
Mailing address:
  • Phone: 774-253-3964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2287181
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0590
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: