Individual
IRENE MUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 WHITLEY RD, KELLER, TX 76248-3038
(817) 431-2518
Mailing address
13225 SETTLERS TRL, FORT WORTH, TX 76244-5706
(919) 384-5393
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA0060050642
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA0060050642
CNA CERTIFICATE
TX
Enumeration date
03/31/2021
Last updated
03/31/2021
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