Provider Demographics
NPI:1356941157
Name:TIGAH, OBOT GRACE (DNP)
Entity type:Individual
Prefix:
First Name:OBOT
Middle Name:GRACE
Last Name:TIGAH
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MRS
Other - First Name:OBOT
Other - Middle Name:OFFIONG
Other - Last Name:UFFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1322 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2833
Mailing Address - Country:US
Mailing Address - Phone:215-459-9480
Mailing Address - Fax:
Practice Address - Street 1:7200 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3156
Practice Address - Country:US
Practice Address - Phone:215-351-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028596363LW0102X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health