Healthcare Provider Details

I. General information

NPI: 1316078033
Provider Name (Legal Business Name): BLESSY GABATIN CHAVENTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 W SYCAMORE ST
KOKOMO IN
46901-5148
US

IV. Provider business mailing address

508 ATHENS PL
WESTFIELD IN
46074-8839
US

V. Phone/Fax

Practice location:
  • Phone: 765-452-5611
  • Fax:
Mailing address:
  • Phone: 765-210-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05008738A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: