Abisola Ibrahim, WHNP/AGPCNP
Nurse Practitioner, Gerontology in San Antonio, TX. Individual provider (NPI-1).
NPI number1649798232
StatusActive
Last updated in NPPESAug 4, 2022
Details
- NPI
- 1649798232
- Entity type
- Individual (NPI-1)
- Name
- Abisola Ibrahim
- Credential
- WHNP/AGPCNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 2, 2017
- Certification date
- Aug 4, 2022
- Last updated
- Aug 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 1055965 | TX | Yes |
| 363LW0102X | Nurse Practitioner, Women's Health | 2020023180 | MO | |
| 363LA2200X | Nurse Practitioner, Adult Health | 22921 | TN | |
| 363LA2200X | Nurse Practitioner, Adult Health | 2020023180 | MO |
Practice location
4502 Medical DrSan Antonio, TX 78229-4402
Phone 210-358-4000
Mailing address
4502 Medical DrSan Antonio, TX 78229-4402
Phone 210-358-4000
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