Provider Demographics
NPI:1043933245
Name:NAMUGENYI, AGNESS (RN)
Entity type:Individual
Prefix:
First Name:AGNESS
Middle Name:
Last Name:NAMUGENYI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 THAYER CIR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2823
Mailing Address - Country:US
Mailing Address - Phone:857-498-1181
Mailing Address - Fax:
Practice Address - Street 1:75 THAYER CIR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2823
Practice Address - Country:US
Practice Address - Phone:857-498-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2315696163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health