MEDICARE: MARGARET W KIBUKU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	41938	TN

General Provider Information

NPI Number	:	1427995661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET W KIBUKU

Provider Business Mailing Address
First Line	:	110 MILTON CT
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37042-2490
Country	:	US
Telephone Number	:	443-963-6441
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 MILTON CT
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37042-2490
Country	:	US
Telephone Number	:	443-963-6441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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