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OTTILIA SIBANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 657-1535
Mailing address
2328 WILLESDEN GREEN CT, HERMITAGE, TN 37076-3329
(870) 680-3768

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
24778
TN
363LF0000X
Family Nurse Practitioner
269865
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
24778
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
269865
AZ

Other

Enumeration date
09/28/2018
Last updated
07/26/2024
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