Provider Demographics
NPI:1861899304
Name:TSIBU, JOHN GEORGE (NP-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GEORGE
Last Name:TSIBU
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 KENSINGTON SQUARE CT STE 103
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-6902
Mailing Address - Country:US
Mailing Address - Phone:615-900-1659
Mailing Address - Fax:615-912-9997
Practice Address - Street 1:1410 KENSINGTON SQUARE CT STE 103
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-6902
Practice Address - Country:US
Practice Address - Phone:615-900-1659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-27
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3287363LF0000X
NV845001363LF0000X
VA24182631363LF0000X
KY3016538363LF0000X
OK205280363LF0000X
SC25533363LF0000X
IN71011875A363LF0000X
CT10167363LF0000X
MI4704380806363LF0000X
TN19436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily