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Tiba Care PLLC

Nurse Practitioner, Family in Tempe, AZ. Organization (NPI-2).

NPI number1417469669
StatusActive
Last updated in NPPESOct 27, 2017

Details

NPI
1417469669
Entity type
Organization (NPI-2)
Legal business name
Tiba Care PLLC
Organization subpart
No
Enumeration date
Oct 27, 2017
Last updated
Oct 27, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyAP8433AZYes

Practice location

315 W Elliot Rd Ste 107-167
Tempe, AZ 85284-1328

Phone 623-226-8105

Mailing address

5810 S 35th Pl
Phoenix, AZ 85040-2844

Phone 314-757-8291

Authorized official

Jennifer Gresham
Family Nurse Practitioner
6232268105

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