MEDICARE: ODETTE MUKAMURAMBIZI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1222078	TX

General Provider Information

NPI Number	:	1497611636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ODETTE MUKAMURAMBIZI

Provider Business Mailing Address
First Line	:	7735 ENCHANTED VIEW DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79911-7522
Country	:	US
Telephone Number	:	502-314-3180
Fax Number	:

Provider Business Practice Location Address
First Line	:	7735 ENCHANTED VIEW DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79911-7522
Country	:	US
Telephone Number	:	502-314-3180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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Directions to “ ODETTE MUKAMURAMBIZI ” Practice Location

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