Provider Demographics
NPI:1427863554
Name:SAFAR, TABITHA PAULYNE JAQUELYN
Entity type:Individual
Prefix:MS
First Name:TABITHA
Middle Name:PAULYNE JAQUELYN
Last Name:SAFAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:PAULYNE J
Other - Last Name:HORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:CHAPPELL
Mailing Address - State:NE
Mailing Address - Zip Code:69129-0667
Mailing Address - Country:US
Mailing Address - Phone:308-874-6232
Mailing Address - Fax:
Practice Address - Street 1:366 4TH ST
Practice Address - Street 2:
Practice Address - City:CHAPPELL
Practice Address - State:NE
Practice Address - Zip Code:69129-8154
Practice Address - Country:US
Practice Address - Phone:308-874-6232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant