Provider Demographics
NPI:1568800712
Name:HIBBARD, NINA JO (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:JO
Last Name:HIBBARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:6701 AIRPORT BLVD STE A101
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6767
Mailing Address - Country:US
Mailing Address - Phone:251-378-6209
Mailing Address - Fax:251-378-6222
Practice Address - Street 1:28260 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7075
Practice Address - Country:US
Practice Address - Phone:251-660-6300
Practice Address - Fax:251-660-6305
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1065597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily