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General NPI Number Information
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NPI Number | 1619477205
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Entity Type | Individual
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Provider Name | MERCY KAMWARO
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 6337 RIPPLE SPRINGS DR
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City | WATAUGA
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State | TX
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Zip | 76148-1313
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Country | US
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Telephone | 682-557-6974
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Fax |
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Provider Business Mailing Address
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Address Line | 3817 VICTORIA CT
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City | BEDFORD
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State | TX
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Zip | 76021-6159
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Country | US
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Telephone |
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Fax |
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 214687
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 214687
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 214687
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License Number State | TX
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