| NPI | 1881235471 |
|---|---|
| Former Name | CATHERINE MICHELLE TIBBETTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001647) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001647) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-10-14 |