Provider Demographics
NPI:1407540974
Name:KWIZERA, NORETTE
Entity Type:Individual
Prefix:
First Name:NORETTE
Middle Name:
Last Name:KWIZERA
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 1:12175 W MCDOWELL RD APT 4203
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5313
Mailing Address - Country:US
Mailing Address - Phone:602-931-9940
Mailing Address - Fax:
Practice Address - Street 1:12175 W MCDOWELL RD APT 4203
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5313
Practice Address - Country:US
Practice Address - Phone:602-931-9940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty