Individual
MRS. AMY MARIE MCKIBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1660 11TH AVE, EDGAR, WI 54426-9105
(715) 352-7703
Mailing address
1660 11TH AVE, EDGAR, WI 54426-9105
(715) 352-7703
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
158527-030
WI
163WH0200X
Home Health Registered Nurse
158527-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35062200
—
WI
Enumeration date
10/16/2008
Last updated
10/16/2008
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