Healthcare Provider Details

I. General information

NPI: 1639880404
Provider Name (Legal Business Name): ESTHER WANJERI MBIU FNP- BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 COLUMBIA 100 PKWY STE 430
COLUMBIA MD
21045-2175
US

IV. Provider business mailing address

9161 COOPERS LN
MCCORDSVILLE IN
46055-0319
US

V. Phone/Fax

Practice location:
  • Phone: 317-430-3722
  • Fax: 844-310-6533
Mailing address:
  • Phone: 317-430-3722
  • Fax: 844-310-6533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28210276A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71013461A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: