Provider Demographics
NPI:1104647312
Name:NDICHU, ELIZABETH WARINGA (RN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:WARINGA
Last Name:NDICHU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 VARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2119
Mailing Address - Country:US
Mailing Address - Phone:978-674-6032
Mailing Address - Fax:978-364-5215
Practice Address - Street 1:391 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2119
Practice Address - Country:US
Practice Address - Phone:978-674-6032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10009520163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse