Provider Demographics
NPI:1982422747
Name:SIBERT, ANTIONETTE LATRICE
Entity type:Individual
Prefix:
First Name:ANTIONETTE
Middle Name:LATRICE
Last Name:SIBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 BRIDGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-4440
Mailing Address - Country:US
Mailing Address - Phone:513-485-8733
Mailing Address - Fax:
Practice Address - Street 1:416 W 9TH ST APT 703
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45203-1599
Practice Address - Country:US
Practice Address - Phone:513-485-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker