| Doctor Name: | MS. LAUREL SUSAN KIBLER |
| NPI Number: | 1972847374 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | AP4754 |
| Business Practice Address: | 900 W Scott St Willcox, AZ - 856431017 |
| Business Phone Number: | 5203844421 |
| Business Fax Number: | 5203844645 |
| Mailing Address: | 901 West Rex Allen Drive, WILLCOX |
| State: | AZ |
| Postal Code: | 85643 |
| Phone Number: | 5203843541 |
| Fax Number: | 5203844553 |
| NPI Enumeration Date: | 11/26/2012 |
| NPI Last Update Date: | 11/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP4754 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |