Provider Demographics
NPI:1538579917
Name:HIBBETT, KRISTY (LPN)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:HIBBETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22217 DAKOTA RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-7444
Mailing Address - Country:US
Mailing Address - Phone:513-264-9563
Mailing Address - Fax:
Practice Address - Street 1:22217 DAKOTA RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-7444
Practice Address - Country:US
Practice Address - Phone:513-264-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN086457164W00000X
IN27061502A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse