Provider Demographics
NPI:1184514093
Name:NTIVU BISIMWA, SIFA
Entity type:Individual
Prefix:
First Name:SIFA
Middle Name:
Last Name:NTIVU BISIMWA
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 1:4425 47TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4201
Mailing Address - Country:US
Mailing Address - Phone:701-730-9301
Mailing Address - Fax:
Practice Address - Street 1:4425 47TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4201
Practice Address - Country:US
Practice Address - Phone:701-730-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care