Provider Demographics
NPI:1225731482
Name:CHEGE, TABITHA WAITHIRA
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:WAITHIRA
Last Name:CHEGE
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 1:8067 DANCING WIND LN APT 2003
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-9670
Mailing Address - Country:US
Mailing Address - Phone:214-597-7089
Mailing Address - Fax:
Practice Address - Street 1:8067 DANCING WIND LN APT 2003
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9670
Practice Address - Country:US
Practice Address - Phone:214-597-7089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025437367500000X
FLAPRN11025437367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered