IndividualActive
Alicia Ibanez, P.A.
NPI 1124364070 · Medical Physician Assistant · Charlotte, NC
Provider details
- NPI number
- 1124364070
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.
- Sex
- Female
- Sole proprietor
- No
- License
- 0010-03995 (NC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2131 Ayrsley Town Blvd
Suite 400
Charlotte, NC 28273-3595
Phone: (980) 297-7733
Fax: (980) 297-7744
Approximate (ZIP-level) locationGet directions
Mailing address
120 Chandeleur Dr
Mooresville, NC 28117-5954
Registry dates
- Enumerated
- 2012-12-21
- Last updated
- 2015-07-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.