Agnes Jeruto Mamboleo
Agnes Jeruto Mamboleo is a Licensed Practical Nurse in Fort Worth, Texas. Licensed in Maryland. Registered with an NPI since 2019.
- Licensed in
- MD
- In the registry since
- 2019
Practice location Address checks out
4921 Woodmeadow DrFort Worth, TX 76135-1824
Phone: (301) 204-6081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Licensed Practical Nurse (primary) | Taxonomy 164W00000X · Licence LP35237 (MD) |
|---|
Record details
| NPI number | 1750926630 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | November 14, 2019 |
| Last updated in NPPES | November 14, 2019 |
| Mailing address | 4921 Woodmeadow Dr, Fort Worth, TX 76135-1824 |
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