Tibbits, Kathleen Grace
Tibbits, Kathleen Grace is an individual health care provider with primary practice located at 721 E Genesee St Fl 2, Syracuse NY 13210-1505. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tibbits, Kathleen Grace can be contacted via phone (315) 476-3124.Contact Information
Primary practice address
721 E Genesee St Fl 2
Syracuse NY 13210-1505
Phone: (315) 476-3124
Fax: (315) 476-3136
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | F331892-1 | New York |
Profile Details
| NPI number | 1912997123 |
|---|---|
| LBN Legal business name | Tibbits, Kathleen Grace |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Jul 10th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912997123 | NPPES |
| New York | MEDICAID | 00561353 |
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