Provider Demographics
NPI:1063082105
Name:KUNGU, WAIRIMU (DNP,APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:WAIRIMU
Middle Name:
Last Name:KUNGU
Suffix:
Gender:F
Credentials:DNP,APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 W PECOS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5723
Mailing Address - Country:US
Mailing Address - Phone:480-656-5711
Mailing Address - Fax:480-656-5622
Practice Address - Street 1:2075 W PECOS RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5723
Practice Address - Country:US
Practice Address - Phone:480-656-5711
Practice Address - Fax:480-656-5622
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ259856363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty