Mercy Kamwaro

Individual provider Active NPI Licensed Vocational Nurse · Watauga, TX

NPI 1619477205 · NPPES record last updated Feb 20, 2018

Key facts

NPI
1619477205
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
214687 (TX)
Practice address
6337 Ripple Springs Dr
Watauga, TX 76148-1313
Phone
(682) 557-6974
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
214687TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 214687 TX
Nursing Care Agency 251J00000X 214687 TX
Licensed Vocational Nurse 164X00000X 214687 TX Yes

Addresses

Primary practice location

6337 Ripple Springs Dr
Watauga, TX 76148-1313

Mailing address

3817 Victoria CT
Bedford, TX 76021-6159

Other identifiers

IdentifierTypeStateIssuer
613373928MedicaidTX

Other providers in Watauga, TX

All providers in Watauga, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.