Provider Demographics
NPI:1285085340
Name:MUTURI, ELIZABETH WAMUYU (RN)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:WAMUYU
Last Name:MUTURI
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 1:13975 WATERVILLE CT
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3282
Mailing Address - Country:US
Mailing Address - Phone:828-545-6378
Mailing Address - Fax:
Practice Address - Street 1:13975 WATERVILLE CT
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-3282
Practice Address - Country:US
Practice Address - Phone:828-545-6378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376K00000X
TX319454164X00000X
CA4709449163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide
No164X00000XNursing Service ProvidersLicensed Vocational Nurse