Provider Demographics
NPI:1528551074
Name:HIBBS, ANGELICA MARIA (NP)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MARIA
Last Name:HIBBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 N COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1613
Mailing Address - Country:US
Mailing Address - Phone:520-869-3565
Mailing Address - Fax:405-297-4928
Practice Address - Street 1:3112 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1613
Practice Address - Country:US
Practice Address - Phone:520-869-3565
Practice Address - Fax:405-297-4928
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-10
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPENDING363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily