Provider Demographics
NPI:1255182648
Name:IRANKUNDA, LOUISA
Entity type:Individual
Prefix:
First Name:LOUISA
Middle Name:
Last Name:IRANKUNDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10009 POWELL AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2562
Mailing Address - Country:US
Mailing Address - Phone:515-587-7572
Mailing Address - Fax:
Practice Address - Street 1:10009 POWELL AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2562
Practice Address - Country:US
Practice Address - Phone:515-587-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver