Mckibben, Robert R

Mckibben, Robert R is an individual health care provider with primary practice located at 2600 Kiley Way , Plymouth WI 53073-5020. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mckibben, Robert R can be contacted via phone (920) 449-7000.

Contact Information

Primary practice address
2600 Kiley Way Plymouth WI 53073-5020
Phone: (920) 449-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 11276 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5662 Wisconsin

Profile Details

NPI number 1184713182
LBN Legal business name Mckibben, Robert R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Feb 6th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184713182 NPPES
Wisconsin MEDICAID 100197491

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