Derek Bakari Mckibben

NPI #1205485711 in Macclenny, Florida

Provider Information

NPI Number: 1205485711
Entity Type: Individual
Name: Derek Bakari Mckibben
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Sep 6, 2019
Last Updated: Sep 6, 2019

Practice Location

Address: 92 W LOWDER ST
City: Macclenny
State: Florida
ZIP Code: 32063-2676
Phone: (352) 374-5615

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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