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NPI Code Detail

MEDICARE: HANNAH NDIBA

MEDICARE: HANNAH NDIBA
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
1225200000XPhysical Therapy Assistant2006028226MO

General Provider Information

NPI Number : 1780377978
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH NDIBA
Provider Business Mailing Address
First Line : 3826 W PARKRIDGE CIR
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65802-6781
Country : US
Telephone Number : 417-894-6603
Fax Number :
Provider Business Practice Location Address
First Line : 1700 S HUDSON AVE
Second Line :
City : AURORA
State : MO
Zip : 65605-2717
Country : US
Telephone Number : 417-678-2165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2023
Last Update Date : 06/01/2023

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Directions to “ HANNAH NDIBA ” Practice Location

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