MEDICARE: MONICA L IBARRA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN089062	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699985168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA L IBARRA RN

Provider Business Mailing Address
First Line	:	1952 W CALLE ARMENTA
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2133
Country	:	US
Telephone Number	:	520-903-1274
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 N BEVERLY AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2128
Country	:	US
Telephone Number	:	520-232-7917
Fax Number	:	520-232-7901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/08/2007

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