Provider Demographics
NPI:1811516834
Name:BABA, CHIAMAKA GERALDINE
Entity type:Individual
Prefix:MRS
First Name:CHIAMAKA
Middle Name:GERALDINE
Last Name:BABA
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 1:11725 N PEACEFUL NIGHT RD
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-7339
Mailing Address - Country:US
Mailing Address - Phone:956-827-1794
Mailing Address - Fax:
Practice Address - Street 1:6060 N FOUNTAIN PLAZA DR STE 250
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7873
Practice Address - Country:US
Practice Address - Phone:520-742-1565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ239201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily