Individual
JACK BIBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10345 PROFESSIONAL CIR, RENO, NV 89521-5862
(775) 348-7300
Mailing address
2406 PRATER WAY, SPARKS, NV 89431-4122
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN10455
NV
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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