KELLEY IBARRA


Address: 1613 Celeste Dr, Modesto, CA 95355-5039
Phone: 2094973514

KELLEY IBARRA (NPI# 1629695440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629695440
Entity Type Individual
Full Name KELLEY IBARRA
Credential FNP
Practice Address 1613 Celeste Dr
Modesto
CA 95355-5039
Practice Telephone 2094973514
Mailing Telephone 2094973514
Enumeration Date 2020-06-26
Last Update Date 2020-06-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
95014395 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1613 CELESTE DR
City MODESTO
State CA
Zip Code 95355-5039

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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568848729 Katherine Boone Nurse Practitioner 4335 N Star Way Ste A, Modesto, CA 95356-8628 2015-08-10
1326259326 Karen Ann Peterson Nurse Practitioner 1340 Mitchell Rd, Modesto, CA 95351 2007-05-24
1689071169 Ebele Oyibo Mbeledogu Nurse Practitioner 2501 Mchenry Ave Ste F, Modesto, CA 95350 2014-11-26
1245208552 Gary Peichoto Nurse Practitioner 1524 Mchenry Ave, Modesto, CA 95350-4500 2006-03-10

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NPI Name Taxonomy Address Enumeration
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Competitor

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City MODESTO
Zip Code 95355

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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