Agnes Jeruto Mamboleo is a licensed practical nurse in Fort Worth, TX. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Agnes Jeruto Mamboleo NPI is 1750926630. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
4921 WOODMEADOW DR
FORT WORTH, TX
ZIP 76135-824
Phone: (301) 204-6081
The enumeration date for this NPI number is 11/14/2019 and was last updated on 11/14/2019.