Provider Demographics
NPI:1710526702
Name:CIBIK, REBECCA K (MSN, APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:K
Last Name:CIBIK
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP-PC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:TOBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7834 CASTLE ROCK DR NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1409
Mailing Address - Country:US
Mailing Address - Phone:330-984-6132
Mailing Address - Fax:
Practice Address - Street 1:2497 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1641
Practice Address - Country:US
Practice Address - Phone:330-676-1020
Practice Address - Fax:330-678-4092
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20191390208000000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No208000000XAllopathic & Osteopathic PhysiciansPediatrics