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General NPI Number Information
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NPI Number | 1851205611
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Entity Type | Individual
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Provider Name | CHEYENNE RAE KIBBY FNP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 406 N STATE ST
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City | GOBLES
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State | MI
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Zip | 49055-9717
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Country | US
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Telephone | 269-628-2196
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 SIGNAL POINT CIR
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City | ALLEGAN
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State | MI
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Zip | 49010-8786
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Country | US
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Telephone | 269-355-0046
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4704372809
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License Number State | MI
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