Healthcare Provider Details

I. General information

NPI: 1528551074
Provider Name (Legal Business Name): ANGELICA MARIA HIBBS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2018
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 N COUNTRY CLUB RD
TUCSON AZ
85716-1613
US

IV. Provider business mailing address

3112 N COUNTRY CLUB RD
TUCSON AZ
85716-1613
US

V. Phone/Fax

Practice location:
  • Phone: 520-869-3565
  • Fax: 405-297-4928
Mailing address:
  • Phone: 520-869-3565
  • Fax: 405-297-4928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11420
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN128482
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: