Provider Demographics
NPI:1003977182
Name:CIBULKA, NANCY J (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:CIBULKA
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Gender:F
Credentials:WHNP
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8064
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-454-7882
Mailing Address - Fax:314-454-5167
Practice Address - Street 1:4901 FOREST PARK AVE
Practice Address - Street 2:STE 341
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1402
Practice Address - Country:US
Practice Address - Phone:314-454-7882
Practice Address - Fax:314-454-5167
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2016-09-20
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Provider Licenses
StateLicense IDTaxonomies
MO123136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily