Provider Demographics
NPI:1992473565
Name:IBARRA, ALEXIS MARIE (DNP, APRN-C)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MARIE
Last Name:IBARRA
Suffix:
Gender:F
Credentials:DNP, APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-3613
Mailing Address - Country:US
Mailing Address - Phone:785-621-4990
Mailing Address - Fax:
Practice Address - Street 1:105 W 13TH ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-3613
Practice Address - Country:US
Practice Address - Phone:785-621-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS149354163W00000X
KS82324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse