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NPI Code Detail

MEDICARE: MR. CHARLES NJUGUNA WAINAINA FNP-C

MEDICARE: MR. CHARLES NJUGUNA WAINAINA FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1057305TX

General Provider Information

NPI Number : 1063177343
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLES NJUGUNA WAINAINA FNP-C
Provider Business Mailing Address
First Line : 1810 BURL LN
Second Line :
City : ANNA
State : TX
Zip : 75409-4651
Country : US
Telephone Number : 469-955-0391
Fax Number :
Provider Business Practice Location Address
First Line : 7709 SAN JACINTO PL STE 100
Second Line :
City : PLANO
State : TX
Zip : 75024-3369
Country : US
Telephone Number : 469-406-4245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2021
Last Update Date : 11/02/2021

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