Provider Demographics
NPI:1649542937
Name:MUKIRI, SALOME WANGUI (RN)
Entity type:Individual
Prefix:MS
First Name:SALOME
Middle Name:WANGUI
Last Name:MUKIRI
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 1:4300 ROSEMEADE PKWY #1616
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287
Mailing Address - Country:US
Mailing Address - Phone:214-680-8347
Mailing Address - Fax:
Practice Address - Street 1:4300 ROSEMEADE PKWY #1616
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287
Practice Address - Country:US
Practice Address - Phone:214-680-8347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX782878163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice