Individual provider · Type 1 NPI
Mary Tibbe, MSN RN CCRN-K AGCNS
Gerontology Clinical Nurse Specialist · Grand Rapids, MI
NPI number
1699328393
Active
Practice location
100 Michigan St NE
Grand Rapids, MI 49503-2560
Mailing address
18901 W Kimball Rd
Pierson, MI 49339-9605
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Clinical Nurse Specialist Primary | 364SG0600X | 4704270663 (MI) |
Gerontology Clinical Nurse Specialist: Definition to come...
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About NPI 1699328393
Mary Tibbe, MSN RN CCRN-K AGCNS's National Provider Identifier is 1699328393, issued on Jul 22, 2019. The primary taxonomy on file is Gerontology Clinical Nurse Specialist (364SG0600X), and the practice location is in Grand Rapids, MI. The record was last updated on Jul 22, 2019.