Individual
KEAUNA TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4134 E JOPPA RD, SUITE 202, BALTIMORE, MD 21236-2284
(410) 248-9800
Mailing address
4134 E JOPPA RD, SUITE 202, BALTIMORE, MD 21236-2284
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R161928
MD
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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