=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952883787
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY NUNGARI NJUNGE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2018
-----------------------------------------------------
Last Update Date | 08/29/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15231 PRESTON RD APT 2039
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75248-4806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-809-4389
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15231 PRESTON RD APT 2039
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75248-4806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-809-4389
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164X00000X
-----------------------------------------------------
Taxonomy Name | Licensed Vocational Nurse
-----------------------------------------------------
License Number | 329132
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------