Individual
SPECIOSE NYIRAMANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 CREEKEDGE CT, ANTIOCH, TN 37013-4268
(270) 599-6963
Mailing address
905 CREEKEDGE CT, ANTIOCH, TN 37013-4268
(270) 599-6963
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001067640
SOS CONTROL
TN
Enumeration date
01/14/2020
Last updated
01/14/2020
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