Provider Demographics
NPI:1821887704
Name:KC, UMANGA
Entity type:Individual
Prefix:
First Name:UMANGA
Middle Name:
Last Name:KC
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 KIMBALL AVENUE, MERCYONE NORTH IOWA WATERLOO FAMIL
Mailing Address - Street 2:STE 101
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702
Mailing Address - Country:US
Mailing Address - Phone:319-272-2112
Mailing Address - Fax:
Practice Address - Street 1:2055 KIMBALL AVENUE, MERCYONE NORTH IOWA WATERLOO FAMIL
Practice Address - Street 2:STE 101
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702
Practice Address - Country:US
Practice Address - Phone:319-272-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-13399207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine