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NPI Code Detail

MEDICARE: NELLY WAKARIA MWANIKI FNP-C

MEDICARE: NELLY WAKARIA MWANIKI 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 Practitioner732298TX

General Provider Information

NPI Number : 1578862694
Entity Type Code : Individual
Provider Name (Legal Business Name) : NELLY WAKARIA MWANIKI FNP-C
Provider Business Mailing Address
First Line : 4701 BOAT CLUB RD STE 200
Second Line :
City : FORT WORTH
State : TX
Zip : 76135-5285
Country : US
Telephone Number : 817-237-0515
Fax Number :
Provider Business Practice Location Address
First Line : 4701 BOAT CLUB RD STE 200
Second Line :
City : FORT WORTH
State : TX
Zip : 76135-5285
Country : US
Telephone Number : 817-237-0515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 02/09/2026

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Directions to “ NELLY WAKARIA MWANIKI FNP-C” Practice Location

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