Provider Demographics
NPI:1194045880
Name:HIBBERT, NORMA E
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:E
Last Name:HIBBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 VILLAGE GRN
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2039
Mailing Address - Country:US
Mailing Address - Phone:845-623-8814
Mailing Address - Fax:
Practice Address - Street 1:88 VILLAGE GRN
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-2039
Practice Address - Country:US
Practice Address - Phone:845-623-8814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01000085148164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse