Provider Demographics
NPI:1821723024
Name:BISENGIMANA, CLAIRE UMWALI
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:UMWALI
Last Name:BISENGIMANA
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 1:2404 FEATHERSTON CT
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-7250
Mailing Address - Country:US
Mailing Address - Phone:937-674-6625
Mailing Address - Fax:
Practice Address - Street 1:2404 FEATHERSTON CT
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-7250
Practice Address - Country:US
Practice Address - Phone:937-674-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily