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General NPI Number Information
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NPI Number | 1124126669
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Entity Type | Individual
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Provider Name | CARRIE MUNGAI NP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 4545 FULLER DR SUITE 325
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City | IRVING
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State | TX
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Zip | 75038-6530
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Country | US
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Telephone | 972-870-5511
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Fax | 972-870-5512
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Provider Business Mailing Address
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Address Line | PO BOX 639295 DEPT 93394
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City | CINCINNATI
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State | OH
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Zip | 45263-9295
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Country | US
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Telephone | 248-434-6169
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Fax | 855-618-6655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 625669
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2021008258
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30005830
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 625669
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License Number State | TX
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