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General NPI Number Information
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NPI Number | 1093235111
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Entity Type | Individual
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Provider Name | ERIN L MCKIBBEN NP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 471 MARKER RD
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City | VERSAILLES
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State | OH
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Zip | 45380-9324
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Country | US
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Telephone | 937-526-9834
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Fax | 937-526-9446
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Provider Business Mailing Address
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Address Line | 507 E WOOD ST
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City | VERSAILLES
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State | OH
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Zip | 45380-1451
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Country | US
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Telephone | 937-564-1378
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRNCNP020925
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007443A
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License Number State | IN
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