Individual
HEATHER S TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
100 MCGREGOR STREET, MANCHESTER, NH 03102
(603) 669-0413
(603) 663-6111
Mailing address
100 MCGREGOR STREET, MANCHESTER, NH 03102
(603) 669-0413
(603) 663-6111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0602
NH
363A00000X
Physician Assistant
0602P
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30334606
—
NH
Enumeration date
10/04/2006
Last updated
04/09/2021
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