Individual provider Active NPI

Maurlean Kerubo Kwamanga, RN

  • Registered Nurse
  • Irving, TX
National Provider Identifier
1083248108
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
899979 Issued in TX
Practice address
10513 N Macarthur Blvd Apt 2023
Irving, TX 75063-5285
Phone
(432) 599-8048
NPI assigned
Feb 27, 2020
Last updated
Feb 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 899979 TX Primary

Addresses

Primary practice location

10513 N Macarthur Blvd Apt 2023
Irving, TX 75063-5285

Mailing address

10513 N Macarthur Blvd Apt 2023
Irving, TX 75063-5285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
899979TXMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1083248108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10513 N MACARTHUR BLVD APT 2023",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 N MACARTHUR BLVD APT 2023",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635285",
            "telephone_number": "432-599-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAMANGA",
        "first_name": "MAURLEAN",
        "middle_name": "KERUBO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "899979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.