Provider Demographics
NPI:1588425946
Name:KABOGORA, CHRISTINE MUTIGERWA
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MUTIGERWA
Last Name:KABOGORA
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 1:1334 FINGER LKS
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3120
Mailing Address - Country:US
Mailing Address - Phone:480-669-5512
Mailing Address - Fax:
Practice Address - Street 1:1334 FINGER LKS
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-3120
Practice Address - Country:US
Practice Address - Phone:480-669-5512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide