Ibarra, Mary Taylor

Ibarra, Mary Taylor is an individual health care provider with primary practice located at 1400 S Coulter St , Amarillo TX 79106-1786. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Ibarra, Mary Taylor can be contacted via phone (806) 414-9100.

Contact Information

Primary practice address
1400 S Coulter St Amarillo TX 79106-1786
Phone: (806) 414-9100
Fax: (806) 354-5717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP132388 Texas
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP132388 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP132388 Texas

Profile Details

NPI number 1194277665
LBN Legal business name Ibarra, Mary Taylor
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2016
Last updated Mar 7th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194277665 NPPES
Oklahoma MEDICAID 200678790 A
Oklahoma MEDICAID 366677802
Oklahoma MEDICAID 366677801
Oklahoma MEDICAID 54485525

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