Provider Demographics
NPI:1821791815
Name:KABITHE, ALYSSA WANGUI
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:WANGUI
Last Name:KABITHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KUI
Other - Middle Name:
Other - Last Name:KABITHE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:310 S HANCOCK ST UNIT 209
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-4101
Mailing Address - Country:US
Mailing Address - Phone:513-800-6895
Mailing Address - Fax:
Practice Address - Street 1:500 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1702
Practice Address - Country:US
Practice Address - Phone:513-800-6895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program