Provider Demographics
NPI:1235942095
Name:TIBALDO, DANELLE L (RN)
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:L
Last Name:TIBALDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 TIBALDO LN
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-8261
Mailing Address - Country:US
Mailing Address - Phone:409-939-6109
Mailing Address - Fax:
Practice Address - Street 1:6302 TIBALDO LN
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:TX
Practice Address - Zip Code:77510-8261
Practice Address - Country:US
Practice Address - Phone:409-939-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX947113163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse