Provider Demographics
NPI:1861217432
Name:TABB, CHAMIKA RIGGINS
Entity type:Individual
Prefix:
First Name:CHAMIKA
Middle Name:RIGGINS
Last Name:TABB
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 1:6506 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3774
Mailing Address - Country:US
Mailing Address - Phone:251-402-5821
Mailing Address - Fax:
Practice Address - Street 1:6506 SHADY LN
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3774
Practice Address - Country:US
Practice Address - Phone:251-402-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
No172A00000XOther Service ProvidersDriver
No251J00000XAgenciesNursing Care