Active NPI
Pamela Mukwanjeru Miriti
- Registered Nurse
- Fort Wayne, IN
National Provider Identifier
1972450427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28300576A
- Practice address
- 4154 Provision Pkwy Apt 207
Fort Wayne, IN 46845-0225 - Phone
- (615) 416-9909
- NPI assigned
- Mar 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28300576A | IN | Primary |
Addresses
Primary practice location
4154 Provision Pkwy Apt 207
Fort Wayne, IN 46845-0225
Mailing address
4154 Provision Pkwy Apt 207
Fort Wayne, IN 46845-0225
Phone (615) 416-9909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28300576A | Other | IN | UMR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28300576A | IN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773360000000",
"number": "1972450427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4154 PROVISION PKWY APT 207",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468450225",
"telephone_number": "615-416-9909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4154 PROVISION PKWY APT 207",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468450225",
"telephone_number": "615-416-9909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRITI",
"first_name": "PAMELA",
"middle_name": "MUKWANJERU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-13",
"last_updated": "2026-03-13",
"certification_date": "2026-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28300576A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMR",
"identifier": "28300576A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.