IndividualActive
Mary Tibbe, MSN RN CCRN-K AGCNS
NPI 1699328393 · Gerontology Clinical Nurse Specialist · Grand Rapids, MI
Provider details
- NPI number
- 1699328393
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- MSN RN CCRN-K AGCNS
- Sex
- Female
- Sole proprietor
- No
- License
- 4704270663 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
100 Michigan St Ne
Grand Rapids, MI 49503-2560
Phone: (616) 520-1135
Approximate (ZIP-level) locationGet directions
Mailing address
18901 W Kimball Rd
Pierson, MI 49339-9605
Registry dates
- Enumerated
- 2019-07-22
- Last updated
- 2019-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.