Provider Demographics
NPI:1699404954
Name:TIBBITT, RYLEIGH C (FNP)
Entity type:Individual
Prefix:
First Name:RYLEIGH
Middle Name:C
Last Name:TIBBITT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 PELHAM RD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-1602
Mailing Address - Country:US
Mailing Address - Phone:256-782-5781
Mailing Address - Fax:
Practice Address - Street 1:700 PELHAM RD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-1602
Practice Address - Country:US
Practice Address - Phone:256-782-5781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1-176904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily