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Individual

DANIEL TIBBITS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1833 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 237-5040
Mailing address
1833 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 237-5040

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201707245NP-PP
OR

Other

Enumeration date
08/28/2012
Last updated
02/15/2021
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