Provider Demographics
NPI:1023642469
Name:RUGAMBWA, CHRISTINE MUNYABARENZI (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MUNYABARENZI
Last Name:RUGAMBWA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9399 WADE BLVD APT 13303
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6523
Mailing Address - Country:US
Mailing Address - Phone:616-337-4414
Mailing Address - Fax:
Practice Address - Street 1:9399 WADE BLVD APT 13303
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6523
Practice Address - Country:US
Practice Address - Phone:616-337-4414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144868363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care