Individual
TABITHA CHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
223 S 3RD ST, HAYTI, MO 63851-1617
(573) 479-3075
Mailing address
120 MARGARET ST, PORTAGEVILLE, MO 63873-8304
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2019010243
MO
Other
Enumeration date
10/02/2019
Last updated
02/21/2020
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