Provider Demographics
NPI:1588814255
Name:HIBBS, PATTTY JOE
Entity Type:Individual
Prefix:MRS
First Name:PATTTY
Middle Name:JOE
Last Name:HIBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:PATTY
Other - Middle Name:JOE
Other - Last Name:MCCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 251970
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1970
Mailing Address - Country:US
Mailing Address - Phone:501-666-8686
Mailing Address - Fax:501-660-6830
Practice Address - Street 1:5905 FOREST PL
Practice Address - Street 2:SUTIE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5244
Practice Address - Country:US
Practice Address - Phone:501-666-4949
Practice Address - Fax:501-660-6840
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator