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Individual
IBIENE SAMUEL
Active
Individual
IBIENE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07171499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP134831
TEXAS BON
TX
01
—
F07171499
AANP
TX
Enumeration date
06/03/2019
Last updated
06/03/2019
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