Provider Demographics
NPI:1124508189
Name:KARANJA, ANN WANGARI
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:WANGARI
Last Name:KARANJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12516 AUDELIA RD APT 1404
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2260
Mailing Address - Country:US
Mailing Address - Phone:423-579-4909
Mailing Address - Fax:
Practice Address - Street 1:12516 AUDELIA RD APT 1404
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2260
Practice Address - Country:US
Practice Address - Phone:423-579-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334753164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse