Individual
DWANA TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4213 HIGHWAY 115, BUNKIE, LA 71322-4311
(337) 336-9794
Mailing address
4213 HIGHWAY 115, BUNKIE, LA 71322-4311
(337) 336-9794
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
211294
LA
164W00000X
Licensed Practical Nurse
210538
LA
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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