Basic Information
| Provider Information | |||||||||
| NPI: | 1235449158 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIBBEE | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | LEIGH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 TRACY WAY 2 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253111262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043884965 | ||||||||
| FaxNumber: | 3043434850 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 MACCORKLE AVE SE STE 202 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253041228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043884965 | ||||||||
| FaxNumber: | 3043884968 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2010 | ||||||||
| LastUpdateDate: | 12/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 66678 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.