Individual
CASSIA TIBBLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 CERQUA ST, WOBURN, MA 01801-5302
(603) 769-1542
Mailing address
7 CERQUA STREET, WOBURN, MA 01801
(603) 769-1542
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
067704-21
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067704-21
RN
NH
01
—
067704-23
APRN
NH
Enumeration date
03/28/2019
Last updated
02/23/2020
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