Healthcare Provider Details

I. General information

NPI: 1811826076
Provider Name (Legal Business Name): DIANA IBARRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

1145 STONECROP DR
LEXINGTON KY
40509-9054
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5000
  • Fax:
Mailing address:
  • Phone: 801-644-2679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4023849
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4023849
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: