Provider Demographics
NPI:1699456939
Name:WAMBUGU, RAHAB MUTHONI (CHAPLAIN)
Entity type:Individual
Prefix:MRS
First Name:RAHAB
Middle Name:MUTHONI
Last Name:WAMBUGU
Suffix:
Gender:F
Credentials:CHAPLAIN
Other - Prefix:MRS
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:WAMBUGU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRE - PASTOR FAITH
Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:918-744-2689
Mailing Address - Fax:
Practice Address - Street 1:1923 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-6520
Practice Address - Country:US
Practice Address - Phone:918-744-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
68782374K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner