Provider Demographics
NPI:1952944100
Name:KAY, TABITHA
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:KAY
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 1:219 BANNISTER ST
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-1830
Mailing Address - Country:US
Mailing Address - Phone:864-760-2590
Mailing Address - Fax:
Practice Address - Street 1:219 BANNISTER ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-1830
Practice Address - Country:US
Practice Address - Phone:864-760-2590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide