Provider Demographics
NPI:1598580045
Name:MUSYOKI, ALLAN MUENDO (LPN)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:MUENDO
Last Name:MUSYOKI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROYAL CREST DR APT 9
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6406
Mailing Address - Country:US
Mailing Address - Phone:978-304-2405
Mailing Address - Fax:
Practice Address - Street 1:2 ROYAL CREST DR APT 9
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6406
Practice Address - Country:US
Practice Address - Phone:978-304-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN92722164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse