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Organization
TIBA CARE PLLC
Active
Organization
TIBA CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GRESHAM FNP-C (FAMILY NURSE PRACTITIONER)
(623) 226-8105
Entity
Organization
Contact information
Practice address
315 W ELLIOT RD STE 107-167, TEMPE, AZ 85284-1328
(623) 226-8105
Mailing address
5810 S 35TH PL, PHOENIX, AZ 85040-2844
(314) 757-8291
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP8433
AZ
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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