Provider Demographics
NPI:1306726401
Name:CHIGAMBA, CHIMWEMWE
Entity type:Individual
Prefix:
First Name:CHIMWEMWE
Middle Name:
Last Name:CHIGAMBA
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 1:3923 IRISH HILLS DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-6537
Mailing Address - Country:US
Mailing Address - Phone:619-302-9385
Mailing Address - Fax:
Practice Address - Street 1:3923 IRISH HILLS DR APT 2A
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-6537
Practice Address - Country:US
Practice Address - Phone:619-302-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN25-019013253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care