Healthcare Provider Details

I. General information

NPI: 1568931244
Provider Name (Legal Business Name): EUNICE MWAURA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2018
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321B CANDELARIA RD NE # 319
ALBUQUERQUE NM
87107-1908
US

IV. Provider business mailing address

205 E UNIVERSITY AVE STE 200
GEORGETOWN TX
78626-6821
US

V. Phone/Fax

Practice location:
  • Phone: 505-270-8240
  • Fax:
Mailing address:
  • Phone: 877-800-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP139814
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: