Provider Demographics
NPI:1366153827
Name:KIMANI, CAROL MURUGI (NP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:MURUGI
Last Name:KIMANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:1429 COOKSIE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5209
Mailing Address - Country:US
Mailing Address - Phone:410-992-2715
Mailing Address - Fax:
Practice Address - Street 1:802 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-9100
Practice Address - Country:US
Practice Address - Phone:410-863-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR255984363LA2100X
CA95022714363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care