Provider Demographics
NPI:1386932432
Name:MWANGI, EMMA WANJIRU (NP)
Entity type:Individual
Prefix:MISS
First Name:EMMA
Middle Name:WANJIRU
Last Name:MWANGI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 GADSDEN HWY APT F118
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2454
Mailing Address - Country:US
Mailing Address - Phone:205-835-3160
Mailing Address - Fax:
Practice Address - Street 1:5892 TRUSSVILLE CROSSINGS PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8633
Practice Address - Country:US
Practice Address - Phone:205-655-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily