Provider Demographics
NPI:1336962034
Name:MURAGIZI, ETIENNE MURAZE
Entity type:Individual
Prefix:
First Name:ETIENNE
Middle Name:MURAZE
Last Name:MURAGIZI
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 1:1400 10TH AVE NE APT 219
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-2876
Mailing Address - Country:US
Mailing Address - Phone:701-260-7079
Mailing Address - Fax:
Practice Address - Street 1:1400 10TH AVE NE APT 219
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-2876
Practice Address - Country:US
Practice Address - Phone:701-260-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDMUR-87-8780376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty