Individual
JILL TIBKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
19550 E 39TH ST S, STE. 210, INDEPENDENCE, MO 64057-2303
(816) 478-9071
Mailing address
3901 RAINBOW BLVD, SUITE G600, KANSAS CITY, KS 66160-8500
(913) 588-9449
(913) 945-7453
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2001023168
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
53-75056-031
KS
Other
Enumeration date
01/23/2011
Last updated
06/25/2015
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