Basic Information
| Provider Information | |||||||||
| NPI: | 1316584949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UWIZEYIMANA | ||||||||
| FirstName: | ARISE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6707 PANTHER WAY | ||||||||
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| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462379471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178510966 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2451 INTELLIPLEX DR STE 260 | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461768581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173980121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2019 | ||||||||
| LastUpdateDate: | 12/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F11190870 | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.