Provider Demographics
NPI:1538769401
Name:GEAR, TABITHA KAY (RN)
Entity type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:KAY
Last Name:GEAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-0049
Mailing Address - Country:US
Mailing Address - Phone:641-231-1591
Mailing Address - Fax:509-984-3613
Practice Address - Street 1:206 HOGANS WAY
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-0049
Practice Address - Country:US
Practice Address - Phone:641-231-1591
Practice Address - Fax:509-984-3613
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61102308163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse