Individual
MARY STIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6231 TROTTER ST, PHILADELPHIA, PA 19111-5811
(215) 821-4523
Mailing address
6231 TROTTER ST, PHILADELPHIA, PA 19111-5811
(215) 821-4523
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306549
PA
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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