Provider Demographics
NPI:1427896901
Name:UMUKUNZI, NADEGE ARIANE
Entity type:Individual
Prefix:
First Name:NADEGE ARIANE
Middle Name:
Last Name:UMUKUNZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 COMMERCIAL ST STE 245
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4899
Mailing Address - Country:US
Mailing Address - Phone:207-409-6183
Mailing Address - Fax:
Practice Address - Street 1:254 COMMERCIAL ST STE 245
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4899
Practice Address - Country:US
Practice Address - Phone:207-409-6183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care