Individual
KELLI TIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501-1602
(606) 430-3500
(606) 437-1033
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-3500
(606) 437-1033
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1149595
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
4015522
KY
Other
Enumeration date
07/10/2023
Last updated
03/06/2024
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