Provider Demographics
NPI:1285038232
Name:KIBBLE, ELIZABETH L (LM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:KIBBLE
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:BETTE
Other - Middle Name:
Other - Last Name:KIBBLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LM
Mailing Address - Street 1:1665 S LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-2522
Mailing Address - Country:US
Mailing Address - Phone:520-882-8228
Mailing Address - Fax:520-791-4140
Practice Address - Street 1:1665 S LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-2522
Practice Address - Country:US
Practice Address - Phone:520-882-8228
Practice Address - Fax:520-791-4140
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ076176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife