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NPI Code Detail

MEDICARE: COURTNEY GARLAND BIBO DNP

MEDICARE: COURTNEY GARLAND BIBO DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209030067IL

General Provider Information

NPI Number : 1679311617
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY GARLAND BIBO DNP
Provider Business Mailing Address
First Line : 206 OLIVE ST
Second Line :
City : GALESBURG
State : IL
Zip : 61401-3456
Country : US
Telephone Number : 309-558-5459
Fax Number :
Provider Business Practice Location Address
First Line : 306 46TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-4281
Country : US
Telephone Number : 309-796-2329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2024
Last Update Date : 07/15/2024

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