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Individual

CAROL M NIBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9211 E 21ST ST N, WICHITA, KS 67206-2968
(316) 609-4501
(316) 636-4076
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27106
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051619
BCBS
KS
01
100018
HPK
KS
01
10061
PHS
KS
01
12149385
MULTIPLAN
KS
01
16976
COVENTRY
KS
Enumeration date
06/17/2006
Last updated
07/13/2007
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