RICHARD IBITOLA IBITAYO
Nurse Practitioner (Family)

Address: 8711 Cinnamon Creek Dr Apt 110, San Antonio, TX 78240-4504

RICHARD IBITOLA IBITAYO (NPI# 1528649761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528649761
Entity Type Individual
Full Name MR. RICHARD IBITOLA IBITAYO
Gender Male
Credential FNP
Practice Address 8711 Cinnamon Creek Dr Apt 110
San Antonio
TX 78240-4504
Practice Telephone 2104192652
Mailing Address 8711 Cinnamon Creek Dr Apt 110
San Antonio
TX 78240-4504
Mailing Telephone 2104192652
Certification Date 2021-04-19
Enumeration Date 2021-04-19
Last Update Date 2021-04-19
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 363LF0000X Nurse Practitioner
Specialization: Family
1022602 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 8711 CINNAMON CREEK DR APT 110
City SAN ANTONIO
State TX
Zip Code 78240-4504

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558945485 Louisa Capicio Nurse Practitioner - Family 21719 Hyerwood, San Antonio, TX 78259-2155 2021-05-06
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Competitor

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City SAN ANTONIO
Zip Code 78240

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.