Provider Demographics
NPI:1699245027
Name:DIEUDONNE, NKURUNZIZA
Entity type:Individual
Prefix:
First Name:NKURUNZIZA
Middle Name:
Last Name:DIEUDONNE
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 1:1625 PARK TOWNE LN NE APT 9
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6432
Mailing Address - Country:US
Mailing Address - Phone:319-318-2480
Mailing Address - Fax:
Practice Address - Street 1:1625 PARK TOWNE LN NE APT 9
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6432
Practice Address - Country:US
Practice Address - Phone:319-318-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)