MEDICARE: JAMES M MWAURA RN

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
1	163W00000X	Registered Nurse	937988	TX
2	163W00000X	Registered Nurse	95241409	CA

General Provider Information

NPI Number	:	1275026080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M MWAURA RN

Provider Business Mailing Address
First Line	:	6935 LAGOON CT
Second Line	:
City	:	JURUPA VALLEY
State	:	CA
Zip	:	91752-2783
Country	:	US
Telephone Number	:	214-551-3309
Fax Number	:

Provider Business Practice Location Address
First Line	:	6935 LAGOON CT
Second Line	:
City	:	JURUPA VALLEY
State	:	CA
Zip	:	91752-2783
Country	:	US
Telephone Number	:	214-551-3309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2018
Last Update Date	:	06/03/2021

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