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1912997123
KATHLEEN GRACE TIBBITS
SYRACUSE, NY
NPI
1912997123
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY F331892-1)
Enumeration Date
2005-10-27
Last Update Date
2020-07-10
Business Address
KATHLEEN GRACE TIBBITS FNP
721 E GENESEE ST FL 2
SYRACUSE, NY 13210-1505
Phone number: 315-476-3124
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Mailing Address
KATHLEEN GRACE TIBBITS FNP
5794 WIDEWATERS PKWY
SYRACUSE, NY 13214-1845
Phone number: 315-422-1513
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