MEDICARE: LEVIS MUYENZI

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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1245072453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEVIS MUYENZI

Provider Business Mailing Address
First Line	:	1717 W CREEK WAY APT 4
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40242-3937
Country	:	US
Telephone Number	:	502-424-2281
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W CREEK WAY APT 4
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40242-3937
Country	:	US
Telephone Number	:	502-424-2281
Fax Number	:

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

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	06/10/2024

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Directions to “ LEVIS MUYENZI ” Practice Location

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