Provider Demographics
NPI:1700559978
Name:KIBBE, SUNSHINE (RN)
Entity Type:Individual
Prefix:
First Name:SUNSHINE
Middle Name:
Last Name:KIBBE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 CALDER AVE.
Mailing Address - Street 2:SUITE 610
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702
Mailing Address - Country:US
Mailing Address - Phone:409-241-9494
Mailing Address - Fax:409-351-3680
Practice Address - Street 1:2615 CALDER AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1947
Practice Address - Country:US
Practice Address - Phone:409-351-3680
Practice Address - Fax:409-241-9494
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660421163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse