Provider Demographics
NPI:1629380357
Name:SIBLEY, MARSHA
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:SIBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 ANNYA STREET
Mailing Address - Street 2:
Mailing Address - City:ANGOON
Mailing Address - State:AK
Mailing Address - Zip Code:99820
Mailing Address - Country:US
Mailing Address - Phone:907-586-2372
Mailing Address - Fax:
Practice Address - Street 1:3100 CHANNEL DRIVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-586-2372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker