Doctor Name: | KEISHA LARELL HIBBS |
NPI Number: | 1104941723 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | RN 281311 |
Business Practice Address: | 1775 E 227th St Euclid, OH - 441172005 |
Business Phone Number: | 2164812149 |
Business Fax Number: | |
Mailing Address: | 1775 E 227th St, EUCLID |
State: | OH |
Postal Code: | 441172005 |
Phone Number: | 2164812149 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | RN 281311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |