Provider Demographics
NPI:1356520928
Name:HIBBLER, STEPHANIE JOANNE (LPN)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JOANNE
Last Name:HIBBLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5637 SUMMIT ARCH
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1664
Mailing Address - Country:US
Mailing Address - Phone:757-537-5541
Mailing Address - Fax:757-537-5541
Practice Address - Street 1:5637 SUMMIT ARCH
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1664
Practice Address - Country:US
Practice Address - Phone:757-537-5541
Practice Address - Fax:757-537-5541
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002076376164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse