Provider Demographics
NPI:1649575499
Name:MABUNDA, KUDZAI (MS)
Entity Type:Individual
Prefix:
First Name:KUDZAI
Middle Name:
Last Name:MABUNDA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KUDZAI
Other - Middle Name:
Other - Last Name:MABUNDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2850 MIDDLETON VIS
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-1855
Mailing Address - Country:US
Mailing Address - Phone:828-337-2776
Mailing Address - Fax:
Practice Address - Street 1:2850 MIDDLETON VIS
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-1855
Practice Address - Country:US
Practice Address - Phone:828-337-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility