Individual provider · Type 1 NPI

Johannah Marie McKibben, RN, BSN, FNP, MSN

Nurse Practitioner · Glenwood, IA

NPI number 1104713437 Active

Practice location

320 Ebaugh St
Glenwood, IA 51534-1811

Fax (712) 396-4180

Mailing address

PO Box 3755
Omaha, NE 68103-0755

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XA186196 (NE)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104713437

Johannah Marie McKibben, RN, BSN, FNP, MSN's National Provider Identifier is 1104713437, issued on Jun 19, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Glenwood, IA. The record was last updated on Oct 17, 2025.