Individual
MR. RAUL P IBANEZ HERNANDEZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3828 BARDSTOWN RD, LOUISVILLE, KY 40218-1527
(502) 479-8930
Mailing address
2600 EL PATIO PL APT 214, LOUISVILLE, KY 40220-6005
(502) 544-2755
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG02250080
KY
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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