Individual
JENNIFER RICHELLE IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
21 WATERFORD DR, MECHANICSBURG, PA 17050-8268
(717) 591-3630
(717) 591-3633
Mailing address
442 APPLETREE RD, CAMP HILL, PA 17011-2103
(717) 471-1829
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN525144L
PA
363LF0000X
Family Nurse Practitioner
Primary
SP029323
PA
Other
Enumeration date
01/08/2024
Last updated
06/10/2024
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