Healthcare Provider Details
I. General information
NPI: 1033527726
Provider Name (Legal Business Name): TONJUA SIBLEY F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/26/2014
Last Update Date: 10/20/2024
Certification Date: 10/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 N GILBERT RD
GILBERT AZ
85234-2328
US
IV. Provider business mailing address
7309 W ST CATHERINE AVE
LAVEEN AZ
85339-7017
US
V. Phone/Fax
- Phone: 480-590-2123
- Fax:
- Phone: 602-910-0350
- Fax: 602-302-7925
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP5709 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: