Provider Demographics
NPI:1942820170
Name:CHIBALE, BRIDGET MALAMA I (LVN)
Entity Type:Individual
Prefix:MISS
First Name:BRIDGET
Middle Name:MALAMA
Last Name:CHIBALE
Suffix:I
Gender:F
Credentials:LVN
Other - Prefix:MISS
Other - First Name:BRIDGET
Other - Middle Name:MALAMA
Other - Last Name:CHIBALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:2064 BARX DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1689
Mailing Address - Country:US
Mailing Address - Phone:940-368-8966
Mailing Address - Fax:940-368-8966
Practice Address - Street 1:2064 BARX DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-1689
Practice Address - Country:US
Practice Address - Phone:940-368-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216067164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse