Individual
MISTY W TIBBITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5106 GA HIGHWAY 41 S, BUENA VISTA, GA 31803-8801
(706) 741-1361
Mailing address
PO BOX 4380, ALPHARETTA, GA 30023-4380
(706) 741-1361
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
154668
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248844783G
—
GA
Enumeration date
08/30/2006
Last updated
12/05/2023
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