Healthcare Provider Details

I. General information

NPI: 1285038232
Provider Name (Legal Business Name): ELIZABETH L KIBBLE L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETTE KIBBLE L.M.

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 S LA CHOLLA BLVD
TUCSON AZ
85713-2522
US

IV. Provider business mailing address

1665 S LA CHOLLA BLVD
TUCSON AZ
85713-2522
US

V. Phone/Fax

Practice location:
  • Phone: 520-882-8228
  • Fax: 520-791-4140
Mailing address:
  • Phone: 520-882-8228
  • Fax: 520-791-4140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number076
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: