Provider Demographics
NPI:1326929217
Name:MUKESHIMANA, CLAUDE N/A
Entity type:Individual
Prefix:
First Name:CLAUDE
Middle Name:N/A
Last Name:MUKESHIMANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5508 WOLF RUN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4530
Mailing Address - Country:US
Mailing Address - Phone:614-377-3567
Mailing Address - Fax:
Practice Address - Street 1:5508 WOLF RUN DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-4530
Practice Address - Country:US
Practice Address - Phone:614-377-3567
Practice Address - Fax:614-377-3567
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 343900000X
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)