NPI 1053807347

Ken Ibeto

Practitioner Home Health Clinical Nurse Specialist Lithia Springs, GA

Practice location

Address: 7646 Forest Glen Way, Lithia Springs, GA 30122-6867
Phone: (678) 637-6249
Fax: (404) 393-4950

Registered specialties

Home Health Clinical Nurse Specialist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 364SH0200X Licence 048-R-2014 (GA)

Other Clinical Nurse Specialist providers in Georgia →

Registry record

NPI: 1053807347
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jul 2018
Record last updated: 10 Jul 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.