Individual
DR. LARRY W NIBBELINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16180 W 135TH ST, OLATHE, KS 66062-1517
(913) 441-4544
(913) 422-8462
Mailing address
16180 W 135TH ST, OLATHE, KS 66062-1517
(913) 441-4544
(913) 422-8462
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0418150
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163710A
—
KS
01
—
CO3121
PTAN RR
—
Enumeration date
07/17/2006
Last updated
02/09/2022
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