Provider Demographics
NPI:1396226809
Name:ABATTAM, GEORGINA UCHE
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:UCHE
Last Name:ABATTAM
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 1:8907 HUNTERS TRCE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6545
Mailing Address - Country:US
Mailing Address - Phone:512-838-6079
Mailing Address - Fax:
Practice Address - Street 1:8907 HUNTERS TRCE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6545
Practice Address - Country:US
Practice Address - Phone:512-838-6079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion