Provider Demographics
NPI:1295602746
Name:BIBBS, STACEY
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:BIBBS
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 1:9722 GROFFS MILL DR STE 855
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6341
Mailing Address - Country:US
Mailing Address - Phone:410-929-6779
Mailing Address - Fax:
Practice Address - Street 1:9722 GROFFS MILL DR STE 855
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6341
Practice Address - Country:US
Practice Address - Phone:410-929-6779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD347C00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle