Individual
MONICA IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
9280 HIGHWAY 5, SUITE A, DOUGLASVILLE, GA 30134-1501
(770) 942-5863
(770) 489-4593
Mailing address
3670 BARDFIELD CT, CUMMING, GA 30041-7332
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN173287
GA
Other
Enumeration date
05/07/2014
Last updated
01/14/2016
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