Provider Demographics
NPI:1518605617
Name:BIBBS-JARRETT, SOPHIA ANN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:ANN
Last Name:BIBBS-JARRETT
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17002 MARINERS BAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-6638
Mailing Address - Country:US
Mailing Address - Phone:901-647-6751
Mailing Address - Fax:
Practice Address - Street 1:17002 MARINERS BAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-6638
Practice Address - Country:US
Practice Address - Phone:901-647-6751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1081654363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care