Provider Demographics
NPI:1215690219
Name:NDUNGU, ROSEMARY WANJIRU
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:WANJIRU
Last Name:NDUNGU
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 1:14 MARCAM VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01537-1029
Mailing Address - Country:US
Mailing Address - Phone:781-267-8109
Mailing Address - Fax:
Practice Address - Street 1:14 MARCAM VILLAGE RD
Practice Address - Street 2:
Practice Address - City:NORTH OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01537-1029
Practice Address - Country:US
Practice Address - Phone:781-267-8109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-16
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN88449164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse