Provider Demographics
NPI:1124807821
Name:HATANGIMANA, FRENK
Entity type:Individual
Prefix:
First Name:FRENK
Middle Name:
Last Name:HATANGIMANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8954 MCMURPHY DR APT 101
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-1195
Mailing Address - Country:US
Mailing Address - Phone:901-228-9164
Mailing Address - Fax:
Practice Address - Street 1:8954 MCMURPHY DR APT 101
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-1195
Practice Address - Country:US
Practice Address - Phone:901-228-9164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN163WX0003X163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient