Provider Demographics
NPI:1508421470
Name:HIBBS, LORETTA ANN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:ANN
Last Name:HIBBS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8125 N UNION CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-3641
Mailing Address - Country:US
Mailing Address - Phone:302-222-4082
Mailing Address - Fax:302-684-3082
Practice Address - Street 1:103 ROGERS RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5767
Practice Address - Country:US
Practice Address - Phone:302-854-0626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0031496163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1149727OtherDRIVING LICENCE