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Destiny Ibrom, FNP
Family Nurse Practitioner in Port Lavaca, Texas
NPI 1487153573

Destiny Ibrom is a Family Nurse Practitioner based in Port Lavaca, TX and is specialized in Family. Destiny Ibrom practices in Port Lavaca, TX and has the professional credentials of FNP. The NPI Number for Destiny Ibrom is 1487153573 and holds a License No. AP136422 (Texas).

The current practice location address for Destiny Ibrom is 1200 N Virginia St, Port Lavaca, TX and can be reached out via phone at 361-552-6721.

Location: 1200 N Virginia St, Port Lavaca, TX, 77979-2507
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487153573
Provider Name
Destiny Ibrom
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
1200 N Virginia St, Port Lavaca, TX, 77979-2507
Phone Number
361-552-6721
Fax Number
Provider Enumeration Date
02/05/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1200 N Virginia St
City
Port Lavaca
State
Texas
Zip
77979-2507
Phone Number
361-552-6721
Fax Number
person
Provider Business Mailing Address Details
Address
1200 N Virginia St
City
Port Lavaca
State
Texas
Zip
77979-2507
Phone Number
361-552-6721
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
AP136422 (Texas)
Definition
Definition to come...
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