Provider Demographics
NPI:1942259601
Name:HIBBETT, MARIBETH E (APRN)
Entity Type:Individual
Prefix:
First Name:MARIBETH
Middle Name:E
Last Name:HIBBETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-301-5901
Mailing Address - Fax:859-301-5940
Practice Address - Street 1:334 THOMAS MORE PARKWAY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3464
Practice Address - Country:US
Practice Address - Phone:859-301-5901
Practice Address - Fax:859-301-5940
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1044830163WP0808X
KY3002128363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100177360Medicaid
KY000000041042OtherANTHEM
KY262258000OtherMAGELLAN
KY1195444OtherCHA HEALTH
KY065805OtherVALUE OPTIONS