Provider Demographics
NPI:1063952828
Name:NJERU, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:NJERU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2752 FOUNTAIN VIEW CIR
Mailing Address - Street 2:103
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2723
Mailing Address - Country:US
Mailing Address - Phone:574-323-8853
Mailing Address - Fax:
Practice Address - Street 1:2752 FOUNTAIN VIEW CIR
Practice Address - Street 2:103
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2723
Practice Address - Country:US
Practice Address - Phone:574-323-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9374818163W00000X
FLAPRN9374818367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse