Healthcare Provider Details

I. General information

NPI: 1528670882
Provider Name (Legal Business Name): RUTH LAGAKINGIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NEW JERSEY AVE SE STE 845
WASHINGTON DC
20003-3338
US

IV. Provider business mailing address

1100 NEW JERSEY AVE SE STE 845
WASHINGTON DC
20003-3338
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-6980
  • Fax:
Mailing address:
  • Phone: 202-545-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberLPN1002652
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: