Provider Demographics
NPI:1093475238
Name:CHIABWE, PATIENCE G
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:G
Last Name:CHIABWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MOON CT
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3378
Mailing Address - Country:US
Mailing Address - Phone:978-996-0156
Mailing Address - Fax:
Practice Address - Street 1:27 MOON CT
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-3378
Practice Address - Country:US
Practice Address - Phone:978-996-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN86393164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty