HIBAJENE CHISONGA (NPI# 1811327943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811327943 |
| Entity Type | Individual |
| Full Name | HIBAJENE CHISONGA |
| Practice Address |
1700 Mishawaka Ave South Bend IN 46634-7111 |
| Mailing Address |
1700 Mishawaka Ave South Bend IN 46615-1408 |
| Practice Telephone | 5742299012 |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2019-03-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
28181907A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704262598 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1700 MISHAWAKA AVE |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46634-7111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922290790 | Laura Myers Hieronymus | Nurse Practitioner | 1700 Mishawaka Ave, Student Activity Center Rm 130, South Bend, IN 46634-7111 | 2007-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952721185 | Indiana University South Bend Health & Wellness Center | Licensed Practical Nurse | 941 20th Street, South Bend, IN 46634-7111 | 2014-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394052 | Mildred Lozada Johnson | Registered Nurse | 1005 Bellevue Ave, South Bend, IN 46615-1412 | 2020-10-20 |
| 1023615796 | Himabindu Gogeneni | Dentist | 3575 Portage Ave Ste A, South Bend, IN 46628-6092 | 2020-10-06 |
| 1639785520 | Hannah Betz | Behavioral Analyst | 1827 E Ireland Rd, South Bend, IN 46614-2845 | 2020-09-16 |
| 1255945705 | Richard B Pearson | Pharmacist | 2913 S Michigan St, South Bend, IN 46614-1033 | 2020-09-02 |
| 1144831009 | Jessica Brickman | Speech-Language Pathologist | 736 Portage Ave Apt 4, South Bend, IN 46616-1371 | 2020-08-13 |
| 1598376485 | The South Bend Clinic LLP | Durable Medical Equipment & Medical Supplies | 6301 University Commons Ste 100, South Bend, IN 46635-1571 | 2020-08-13 |
| 1417568940 | Robin M Palisano-wolfe | Physical Therapy Assistant | 59808 Ironwood Rd, South Bend, IN 46614-9111 | 2020-08-10 |
| 1053920603 | Ariel Words | Pathology | 1233 Woodfield Ave, South Bend, IN 46615-3803 | 2020-07-29 |
| 1912515644 | Allison Marie Hill | Pharmacy | 3 Spruce Ln, South Bend, WA 98586-9008 | 2020-07-20 |
| 1770191892 | Baochun Hind | Counselor | 1205 E Bronson St, South Bend, IN 46615-1141 | 2020-07-15 |
| Find all providers in SOUTH BEND | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205334927 | Martha Wahu Mburu | Nurse Practitioner | 17747 Tallyho Dr E, South Bend, IN 46635-1040 | 2018-01-28 |
| 1194245324 | Sameka Renee Dowell Mills | Nurse Practitioner | 112 W Jefferson Blvd Ste 600, South Bend, IN 46601-1921 | 2017-06-20 |
| 1265826226 | Mario Remedios Ortiz | Nurse Practitioner | 1700 Mishawaka Ave # Sac-130, Health & Wellness Center, Iu South Bend, South Bend, IN 46615-1408 | 2015-03-26 |
| 1023400454 | Amanda Lundberg | Nurse Practitioner | 53830 Generations Dr Ste 110, South Bend, IN 46635-1538 | 2015-02-23 |
| 1932520426 | Stephanie Brenneman | Nurse Practitioner | 943 S 25th St, South Bend, IN 46615-1707 | 2013-12-30 |
| 1467747014 | Deidre A Coffey | Nurse Practitioner | 1025 Widener Ln, South Bend, IN 46614 | 2011-06-12 |
| 1083919161 | Caitlin Vlaeminck | Nurse Practitioner | 6301 University Commons Ste 320, South Bend, IN 46635-1479 | 2011-01-20 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| 1780620005 | Barbara Ann Norris | Nurse Practitioner | 1432 Lincoln Way E, South Bend, IN 46613-3205 | 2006-06-22 |
| 1184629891 | Sharon K Klingerman | Nurse Practitioner | 100 Navarre Pl, Ste 5550, South Bend, IN 46601-1169 | 2005-06-17 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46634 |
Please comment or provide details below to improve the information on HIBAJENE CHISONGA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.