Provider Demographics
NPI:1235771551
Name:KABE, KAVIA (BS, MS)
Entity Type:Individual
Prefix:MRS
First Name:KAVIA
Middle Name:
Last Name:KABE
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 GALLATIN PIKE S
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-4013
Mailing Address - Country:US
Mailing Address - Phone:615-517-7404
Mailing Address - Fax:
Practice Address - Street 1:1935 LOMBARDIA LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3821
Practice Address - Country:US
Practice Address - Phone:615-648-4342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker