MEDICARE: LUCY NJOROGE FNP

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	363LF0000X	Family Nurse Practitioner	R844344	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386677474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY NJOROGE FNP

Provider Business Mailing Address
First Line	:	177 PARKWAY CV W
Second Line	:
City	:	HERNANDO
State	:	MS
Zip	:	38632-1627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E FRONTAGE RD
Second Line	:
City	:	SARDIS
State	:	MS
Zip	:	38666-1339
Country	:	US
Telephone Number	:	662-487-3938
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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