Provider Demographics
NPI:1851185425
Name:RUGANGURA, MARIE ANGELIQUE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ANGELIQUE
Last Name:RUGANGURA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21067 STANFORD SQ APT 201
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2463
Mailing Address - Country:US
Mailing Address - Phone:202-550-3492
Mailing Address - Fax:
Practice Address - Street 1:21067 STANFORD SQ APT 201
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2463
Practice Address - Country:US
Practice Address - Phone:202-550-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401204642376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide