Provider Demographics
NPI:1306194766
Name:GINGERICH, TABITHA JOY (FNP-C)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:JOY
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:FNP-C
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 169
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-0169
Mailing Address - Country:US
Mailing Address - Phone:540-421-0779
Mailing Address - Fax:540-438-0023
Practice Address - Street 1:3180 FAIRVIEW PARK DRIVE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042
Practice Address - Country:US
Practice Address - Phone:703-485-8949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0802810OtherCIGNA
VA1568432706Medicaid
VA42417OtherOPTIMA
VA302937OtherANTHEM
VA3810009499OtherWV MEDICAID
VA638339OtherSOUTHERN HEALTH
VA0802810OtherCIGNA
VA42417OtherOPTIMA