Provider Demographics
NPI:1962010975
Name:NDUWIMANA, BEATRICE
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:NDUWIMANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEATRICE
Other - Middle Name:
Other - Last Name:NAHISHAKIYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:990 HAMMOND DR # 525
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5529
Mailing Address - Country:US
Mailing Address - Phone:404-642-2595
Mailing Address - Fax:
Practice Address - Street 1:3499 HENLEY ST
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1758
Practice Address - Country:US
Practice Address - Phone:404-642-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN2411392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry