Individual
LAURA IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4105 MATTHEWS MINT HILL RD, MATTHEWS, NC 28105-3633
(704) 910-9306
Mailing address
10730 SURREY GREEN LN APT 303, MATTHEWS, NC 28105-8960
(704) 910-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-16317
NC
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/02/2025
Last updated
03/10/2026
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