Provider Demographics
NPI:1679353494
Name:UWIMANA, EVELYNE
Entity type:Individual
Prefix:
First Name:EVELYNE
Middle Name:
Last Name:UWIMANA
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 1:12713 W PARADISE DR
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-6350
Mailing Address - Country:US
Mailing Address - Phone:614-599-2265
Mailing Address - Fax:
Practice Address - Street 1:12713 W PARADISE DR
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-6350
Practice Address - Country:US
Practice Address - Phone:614-599-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health