MEDICARE: JOYCE WANGUI ITHARA RN, BSN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	311ZA0620X	Adult Care Home Facility
2	310400000X	Assisted Living Facility
3	315P00000X	Intellectual Disabilities Intermediate Care Facility

General Provider Information

NPI Number	:	1972441509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE WANGUI ITHARA RN, BSN

Provider Business Mailing Address
First Line	:	2327 JULIA LN
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-5324
Country	:	US
Telephone Number	:	214-779-8033
Fax Number	:

Provider Business Practice Location Address
First Line	:	2327 JULIA LN
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-5324
Country	:	US
Telephone Number	:	214-779-8033
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	05/21/2026

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