Provider Demographics
NPI:1053670190
Name:IBARRA, VERONICA MARIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:MARIE
Last Name:IBARRA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7180 CASCADE VALLEY CT STE 180
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1407
Mailing Address - Country:US
Mailing Address - Phone:702-641-2150
Mailing Address - Fax:
Practice Address - Street 1:7180 CASCADE VALLEY CT STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1407
Practice Address - Country:US
Practice Address - Phone:702-641-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily