NPI | 1528502481 |
---|---|
Former Name | CATHERINE TIBBEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003087) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL RN9518336) |
363LF0000X Nurse Practitioner, Family (Licence: CO RN. 1624847) | |
Enumeration Date | 2016-12-12 |
Last Update Date | 2022-07-11 |